Dutta Anupriya, Uno Hajime, Holman Alex, Lorenz David R, Wolinsky Steven M, Gabuzda Dana
aDepartment of Cancer Immunology and Virology bCenter for Population Science, Dana-Farber Cancer Institute, Boston, Massachusetts cDivision of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
AIDS. 2017 May 15;31(8):1169-1180. doi: 10.1097/QAD.0000000000001451.
Nitrite inhalants (poppers) are commonly used recreational drugs among MSM and were previously associated with elevated rates of high-risk sexual behavior, HIV and human herpesvirus type 8 (HHV-8) seroconversion, and transient immunosuppressive effects in experimental models. Whether long-term popper use is associated with cancer risk among MSM in the HAART era is unclear.
Prospective cohort study of cancer risk in 3223 HIV-infected and uninfected MSM in the Multicenter AIDS Cohort Study from 1996-2010.
Poisson regression models were used to examine the association between heavy popper use (defined as daily or weekly use for at least 1 year) and risk of individual cancers or composite category of virus-associated cancers.
Among all participants, heavy popper use was not associated with increased risk of any individual cancers. Among HIV-uninfected men aged 50-70, heavy popper use was associated with increased risk of virus-associated cancer with causes linked to human papillomavirus, HHV-8, and Epstein-Barr virus in models adjusted for demographics, number of sexual partners, immunological parameters (CD4 cell counts or CD4/CD8 ratios), and hepatitis B and C viruses [incidence rate ratio (IRR), 95% confidence interval (CI) 3.24, 1.05-9.96], or sexually transmitted infections (IRR 3.03, 95% CI, 1.01-9.09), as was cumulative use over a 5-year period (IRR 1.012, 95% CI 1.003-1.021; P = 0.007). There was no significant association between heavy popper use and virus-associated cancer in HIV-infected men.
Long-term heavy popper use is associated with elevated risk of some virus-associated cancers with causes related to human papillomavirus, HHV-8, and Epstein-Barr virus infections in older HIV-uninfected MSM independent of sexual behavior and immunological parameters.
亚硝酸酯吸入剂（Poppers）是男男性行为者中常用的消遣性毒品，此前在实验模型中发现其与高危性行为、HIV和人类疱疹病毒8型（HHV - 8）血清转化以及短暂的免疫抑制作用发生率升高有关。在高效抗逆转录病毒治疗（HAART）时代，长期使用Poppers是否与男男性行为者的癌症风险相关尚不清楚。
1996年至2010年对多中心艾滋病队列研究中3223名感染和未感染HIV的男男性行为者的癌症风险进行前瞻性队列研究。
采用泊松回归模型来检验频繁使用Poppers（定义为每天或每周使用至少1年）与个体癌症风险或病毒相关癌症综合类别之间的关联。
在所有参与者中，频繁使用Poppers与任何个体癌症风险增加均无关联。在50 - 70岁未感染HIV的男性中，在对人口统计学、性伴侣数量、免疫参数（CD4细胞计数或CD4/CD8比值）以及乙型和丙型肝炎病毒进行调整的模型中，频繁使用Poppers与由人乳头瘤病毒、HHV - 8和爱泼斯坦 - 巴尔病毒引起的病毒相关癌症风险增加相关[发病率比（IRR），95%置信区间（CI）3.24，1.05 - 9.96]，或与性传播感染相关（IRR 3.03，95% CI，1.01 - 9.09），5年期间的累积使用情况也是如此（IRR 1.012，95% CI 1.003 - 1.021；P = 0.007）。在感染HIV的男性中，频繁使用Poppers与病毒相关癌症之间无显著关联。
在未感染HIV的老年男男性行为者中，长期频繁使用Poppers与某些由人乳头瘤病毒、HHV - 8和爱泼斯坦 - 巴尔病毒感染引起的病毒相关癌症风险升高相关，且独立于性行为和免疫参数。
