Thrift Aaron P, Chiao Elizabeth Y
Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA.
Curr Infect Dis Rep. 2018 May 26;20(8):22. doi: 10.1007/s11908-018-0626-9.
The introduction of antiretroviral therapy (ART) has revolutionized HIV infection management, resulting in improved outcomes and survival for people living with HIV (PLWH). However, as PLWH are living longer and aging, non-AIDS-defining cancers (NADCs) represent a significant source of morbidity and mortality in the HIV-infected population. Here, we review the epidemiology of NADCs in PLWH.
Cancer mortality among PLWH is much higher than that among the general population. Up to 10% of deaths among PLWH have been attributed to NADCs. Furthermore, PLWH have an increased risk for specific NADCs, including lung cancer, hepatocellular carcinoma, head and neck cancers, anal cancer, and Hodgkin lymphoma. In the past decade, the incidence rates of AIDS-defining cancers (ADCs) have been decreasing while the incidence rates of NADCs have been increasing. In particular, the incidence of specific NADCs are changing at different rates. For example through 2010, the incidence rates for anal, liver, and prostate cancers among PLWH had increased, while incidence rates for lung cancer had decreased and incidence rates for colorectal cancer remained relatively stable over time. However, as early ART becomes more prevalent and the percentage of PLWH over 50 increases, these trends may evolve further. Incidence of NADCs should be expected to increase further as the PLWH population continues to age. Screening and prevention for these cancers among the HIV-infected population should be emphasized.
抗逆转录病毒疗法（ART）的引入彻底改变了HIV感染的管理方式，使HIV感染者（PLWH）的治疗结果和生存率得到改善。然而，随着PLWH寿命延长和老龄化，非艾滋病定义性癌症（NADC）成为HIV感染人群发病和死亡的重要原因。在此，我们综述PLWH中NADC的流行病学情况。
PLWH的癌症死亡率远高于普通人群。PLWH中高达10%的死亡归因于NADC。此外，PLWH患特定NADC的风险增加，包括肺癌、肝细胞癌、头颈癌、肛门癌和霍奇金淋巴瘤。在过去十年中，艾滋病定义性癌症（ADC）的发病率一直在下降，而NADC的发病率一直在上升。特别是，特定NADC的发病率以不同速度变化。例如，到2010年，PLWH中肛门癌、肝癌和前列腺癌的发病率有所上升，而肺癌发病率下降，结直肠癌发病率随时间相对稳定。然而，随着早期ART的普及以及50岁以上PLWH的比例增加，这些趋势可能会进一步演变。随着PLWH人群继续老龄化，预计NADC的发病率将进一步上升。应强调对HIV感染人群中的这些癌症进行筛查和预防。
