澳大利亚 HIV 感染者中肛门癌的发病率和时间趋势。
Incidence and time trends of anal cancer among people living with HIV in Australia.
机构信息
The Kirby Institute.
Centre for Big Data Research in Health, University of New South Wales.
出版信息
AIDS. 2019 Jul 1;33(8):1361-1368. doi: 10.1097/QAD.0000000000002218.
BACKGROUND
Anal cancer incidence increased markedly in people living with HIV (PLWHIV) after the introduction of HAART, but in a few setting settings, recent declines have been reported. We report the incidence and time trends of anal cancer in PLWHIV in Australia.
STUDY DESIGN
A data linkage study between the National HIV Registries and the Australian Cancer Database.
METHODS
Cases of anal squamous cell carcinoma (ASCC) in Australians aged 16 years and above diagnosed with HIV between 1982 and 2012 were identified. Standardized incidence ratios (SIRs) were calculated to compare incidence with that of the general population. Poisson regression models were developed to describe the time trends of ASCC over time and to compare ASCC risk within subgroups of PLWHIV.
RESULTS
Among 28 696 individuals, a total of 129 cases of ASCC were identified. The crude incidence was 36.3 per 100 000 person-years and it increased sharply from 14.8 to 62.1 per 100 000 person-years between 1982-1995 and 2009-2012 (P trend <0.001). The SIR was 35.3 (95% confidence interval 29.5-42.0), and there was an inverse association between SIR and increasing age (P trend <0.001). In multivariate analyses, ASCC incidence was significantly higher in recent years (P trend <0.001), in those who acquired HIV through male homosexual contact (P = 0.002), and in those who had a history of AIDS (P < 0.001).
CONCLUSION
PLWHIV in Australia are at markedly higher risk of anal cancer. Unlike in some industrialized countries with a mature HIV epidemic, the incidence of anal cancer is still increasing in this population in Australia.
背景
高效抗逆转录病毒疗法（HAART）问世后，艾滋病毒感染者（PLWHIV）的肛门癌发病率显著增加，但在一些特定环境下，最近有报道称发病率有所下降。我们报告了澳大利亚 PLWHIV 肛门癌的发病率和时间趋势。
研究设计
国家艾滋病毒登记处和澳大利亚癌症数据库之间的数据链接研究。
方法
确定了 1982 年至 2012 年间诊断为 HIV 的年龄在 16 岁及以上的澳大利亚人患肛门鳞状细胞癌（ASCC）的病例。计算标准化发病率比（SIR）以比较发病率与普通人群的发病率。使用泊松回归模型描述 ASCC 随时间的时间趋势，并比较 PLWHIV 亚组内的 ASCC 风险。
结果
在 28696 名个体中，共发现 129 例 ASCC。粗发病率为 36.3/100000 人年，1982-1995 年至 2009-2012 年期间，发病率从 14.8 急剧上升至 62.1/100000 人年（P 趋势<0.001）。SIR 为 35.3（95%置信区间 29.5-42.0），SIR 与年龄增加呈负相关（P 趋势<0.001）。在多变量分析中，ASCC 的发病率在最近几年显著更高（P 趋势<0.001），在通过男同性恋接触感染 HIV 的人群中（P=0.002），以及在有艾滋病史的人群中（P<0.001）。
结论
澳大利亚的 PLWHIV 患肛门癌的风险明显更高。与一些艾滋病毒流行成熟的工业化国家不同，澳大利亚该人群的肛门癌发病率仍在上升。
Zotero 插件