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高效抗逆转录病毒治疗时代韩国人类免疫缺陷病毒感染患者的恶性肿瘤趋势

Trends in Malignancies among Korean Patients Infected with Human Immunodeficiency Virus in the Highly Active Antiretroviral Therapy Era.

作者信息

Lee Shinwon, Lee Sun Hee, Lee Jeong Eun, Kang Jin Suk, Lee Seung Geun, Chung Joo Seop, Kwak Ihm Soo

机构信息

Deparment of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Korea.

出版信息

J Korean Med Sci. 2017 Sep;32(9):1445-1450. doi: 10.3346/jkms.2017.32.9.1445.

Abstract

Since the introduction of highly active antiretroviral therapy, the life span of people with human immunodeficiency virus (HIV) or AIDS (PWHA) has been extended significantly. Therefore, the importance of non-AIDS-defining cancers (NADCs), as well as AIDS-defining cancers (ADCs) has increased. There is little information concerning the epidemiology of malignancies in PWHA in Korea. A descriptive epidemiologic study was conducted at a tertiary care hospital in Korea. PWHA who visited Pusan National University Hospital from January 2000 to October 2014 were included. Demographics and clinical data were obtained from the medical records and analyzed. A total of 950 PWHA were observed for 4,439.71 person-years. Forty-eight episodes (5.05%) of cancers were diagnosed in 47 patients. Mean age of the enrolled patients was 40.66 ± 12.15 years and 88% were male. Among the 48 cancer episodes, 20 (42%) were ADCs and 28 were NADCs. The most common ADCs was non-Hodgkin's lymphoma (53.6%), followed by Kaposi's sarcoma (17.9%). The most common NADCs were lung cancer (25%) and hepatocellular carcinoma (25%). The overall incidence of total cancers, ADCs, and NADCs was 10.8 (95% confidence interval [CI], 8.0-14.3), 4.5 (95% CI, 2.8-7.0), and 6.3 (95% CI, 4.2-9.1)/1,000 person-years, respectively. NADCs accounted for 12/15 (80%) of cancers among PWHA with good adherence to care. The 5-year survival rate of PWHA and NADC was 26.3%. NADCs have become the main type of malignancy among Korean PWHA with good adherence to care. Effective strategies to improve screening of NADCs among PWHA are required in Korea.

摘要

自高效抗逆转录病毒疗法问世以来,感染人类免疫缺陷病毒(HIV)或患艾滋病(AIDS)的患者(PWHA)的寿命显著延长。因此,非艾滋病定义性癌症(NADC)以及艾滋病定义性癌症(ADC)的重要性日益增加。关于韩国PWHA中恶性肿瘤的流行病学信息较少。在韩国一家三级护理医院开展了一项描述性流行病学研究。纳入了2000年1月至2014年10月期间就诊于釜山国立大学医院的PWHA。从病历中获取人口统计学和临床数据并进行分析。共观察了950名PWHA,观察时间为4439.71人年。47名患者被诊断出48例癌症(5.05%)。纳入患者的平均年龄为40.66±12.15岁,88%为男性。在48例癌症病例中,20例(42%)为ADC,28例为NADC。最常见的ADC是非霍奇金淋巴瘤(53.6%),其次是卡波西肉瘤(17.9%)。最常见的NADC是肺癌(25%)和肝细胞癌(25%)。所有癌症、ADC和NADC的总体发病率分别为10.8(95%置信区间[CI],8.0 - 14.3)、4.5(95%CI,2.8 - 7.0)和6.3(95%CI,4.2 - 9.1)/1000人年。在依从性良好的PWHA中,NADC占癌症的12/15(80%)。PWHA和NADC的5年生存率为26.3%。在韩国,依从性良好的PWHA中,NADC已成为主要的恶性肿瘤类型。韩国需要有效的策略来改善对PWHA中NADC的筛查。

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