Tanaka Luana F, Latorre Maria R D O, Gutierrez Eliana B, Curado Maria P, Froeschl Guenter, Heumann Christian, Herbinger Karl-Heinz
Center for International Health.
Department of Epidemiology, School of Public Health.
Eur J Cancer Prev. 2018 Jul;27(4):411-417. doi: 10.1097/CEJ.0000000000000339.
Previous studies have reported an increased risk for certain types of cancer in the HIV-infected population. The aim of this study was to assess the risk for cancer in people with AIDS (PWA) in comparison with the general population in São Paulo (Brazil), between 1997 and 2012. A population-based registry linkage study was carried out to assess the risk for cancer, using a standardized incidence ratio (SIR) approach. A total of 480 102 person-years, of which 337 941 (70.4%) person-years were men, were included in the analysis. Around 2074 cancer cases were diagnosed among PWA, of which 51.0% were non-AIDS-defining cancers (NADC). The risk for AIDS-defining cancers and NADC in the male population with AIDS was significantly higher than that in the general population (SIR=27.74 and 1.87, respectively), as it was in the female population with AIDS compared with the general population (SIR=8.71 and 1.44, respectively). Most virus-related NADC occurred at elevated rates among PWA: anal cancer (SIR=33.02 in men and 11.21 in women), liver (SIR=4.35 in men and 4.84 in women), vulva and vagina (SIR=6.78 in women) and Hodgkin lymphoma (SIR=5.84 in men and 2.71 in women). Lung (SIR=2.24 in men and 2.60 in women) and central nervous system (SIR=1.92 in men and 3.48 in women) cancers also occurred at increased rates. Cancer burden among PWA in São Paulo was similar to that described in high-income countries such as the USA and Italy following the introduction of the highly active antiretroviral therapy. As coinfection with oncogenic viruses disproportionally affects this population, virus-related cancers accounted for a great share of excessive cases.
以往研究报告称，艾滋病毒感染人群患某些类型癌症的风险增加。本研究的目的是评估1997年至2012年期间，巴西圣保罗艾滋病患者（PWA）与普通人群相比患癌症的风险。采用标准化发病比（SIR）方法进行了一项基于人群的登记关联研究，以评估患癌风险。分析共纳入480102人年，其中337941人年（70.4%）为男性。艾滋病患者中约诊断出2074例癌症病例，其中51.0%为非艾滋病定义癌症（NADC）。男性艾滋病患者患艾滋病定义癌症和NADC的风险显著高于普通人群（SIR分别为27.74和1.87），女性艾滋病患者与普通人群相比也是如此（SIR分别为8.71和1.44）。大多数与病毒相关的NADC在艾滋病患者中发病率较高：肛门癌（男性SIR = 33.02，女性SIR = 11.21）、肝癌（男性SIR = 4.35，女性SIR = 4.84）、外阴癌和阴道癌（女性SIR = 6.78）以及霍奇金淋巴瘤（男性SIR = 5.84，女性SIR = 2.71）。肺癌（男性SIR = 2.24，女性SIR = 2.60）和中枢神经系统癌（男性SIR = 1.92，女性SIR = 3.48）的发病率也有所增加。圣保罗艾滋病患者的癌症负担与美国和意大利等高收入国家在引入高效抗逆转录病毒疗法后所描述的情况相似。由于致癌病毒的合并感染对该人群影响不成比例，与病毒相关的癌症在过多病例中占很大比例。
