Fernández-Ruiz Alexia, Sanjoaquín-Conde Isabel, Letona-Carbajo Santiago, Lambea-Sorrosal Julio José, Crusells-Canales María José
Servicio de Oncología Médica, Hospital General San Jorge, Huesca, España.
Servicio de Enfermedades Infecciosas, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
Med Clin (Barc). 2020 Apr 24;154(8):295-300. doi: 10.1016/j.medcli.2019.06.019. Epub 2019 Aug 27.
After the introduction of antiretroviral therapy, a decrease in AIDS defining cancers (ADCs) is observed, while non-AIDS-defining cancers (NADCs) have increased in HIV-infected patients (HIP). We have little information about the prognosis and associated risk factors. We studied survival and its relationship with immunodeficiency after the diagnosis of ADC or NADC.
Observational, retrospective study of 788 HIP of whom 133 developed a malignancy between 2000-2016. Malignancies were divided into ADCs or NADCs and degree of immunodeficiency according to the CD4 T lymphocyte count> or </=200/mm. Survival was estimated according to the Kaplan Meier method, multivariate COX regression analysis and compared with the log-rank test.
149 malignancies were diagnosed in 133 HIP: 41.4% ADCs and 58.6 NADCs. The most frequent tumour was NHL (21.1%), followed by lung carcinoma (15%). HCV was positive in 50.4% and 65.4% were smokers. Thirty-nine point one percent had a CD4 T lymphocyte count </=200/mm, being 60% in the case of ADCs while in NADCs it was 38.5%. CD4 T lymphocyte count </=200/mm is significantly associated with lower survival after diagnosis of ADCs(p=.031) and NADCs (p=.005).
The most frequent types of tumours in HIP differ from those in the general population, probably due to oncogenic risk factors. CD4 T lymphocyte count </=200/mm is a risk factor related to worse prognosis after NADC or ADC diagnosis.
在引入抗逆转录病毒疗法后，观察到艾滋病相关定义癌症（ADCs）有所减少，而在人类免疫缺陷病毒（HIV）感染患者（HIP）中，非艾滋病相关定义癌症（NADCs）有所增加。我们对其预后及相关危险因素了解甚少。我们研究了ADC或NADC诊断后的生存率及其与免疫缺陷的关系。
对788例HIP进行观察性回顾性研究，其中133例在2000年至2016年间发生了恶性肿瘤。根据CD4 T淋巴细胞计数＞或≤200/mm³将恶性肿瘤分为ADCs或NADCs以及免疫缺陷程度。根据Kaplan-Meier方法、多变量COX回归分析估计生存率，并与对数秩检验进行比较。
133例HIP中诊断出149例恶性肿瘤：41.4%为ADCs，58.6%为NADCs。最常见的肿瘤是非霍奇金淋巴瘤（NHL，21.1%），其次是肺癌（15%）。50.4%的患者丙型肝炎病毒（HCV）呈阳性，65.4%的患者为吸烟者。39.1%的患者CD4 T淋巴细胞计数≤200/mm³，ADCs患者中这一比例为60%，而NADCs患者中为38.5%。CD4 T淋巴细胞计数≤200/mm³与ADCs（p = 0.031）和NADCs（p = 0.005）诊断后的较低生存率显著相关。
HIP中最常见的肿瘤类型与普通人群不同，可能是由于致癌危险因素所致。CD4 T淋巴细胞计数≤200/mm³是NADC或ADC诊断后预后较差的一个危险因素。
