National Cancer Registry, National Health Laboratory Service.
Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
Curr Opin Infect Dis. 2021 Feb 1;34(1):1-7. doi: 10.1097/QCO.0000000000000705.
Historically, conjunctival cancer has been associated with HIV particularly in sub-Saharan Africa. The human papilloma virus (HPV) has been implicated as a potential causative agent without conclusive evidence. This review covers recent evidence of the epidemiology, diagnosis and treatment of conjunctival cancer in people living with HIV (PLWH).
HIV infection has been attributed to 33% of squamous cell carcinoma of the conjunctiva in sub-Saharan Africa. Although clear evidence of the effect of immunodeficiency on conjunctival cancer risk has been demonstrated, the role of HPV on conjunctival cancer development is still unclear. Biomarkers such as the p16 protein are not always indicative of HPV infection. The Epstein-Barr virus (EBV) might potentially be another infectious agent of interest in the development of conjunctival cancer. There is some evidence of increased conjunctival cancer recurrence post treatment as well as increased probability of metastasis in PLWH.
Immunodeficiency increases the risk of conjunctival cancer in PLWH. Symptomatic screening of conjunctival cancer in PLWH should be encouraged. Research on HPV involvement should remain a priority and EBV considered as another etiologic agent of interest. More studies on treatment modalities in PLWH should be considered.
从历史上看，结膜癌症与 HIV 相关，特别是在撒哈拉以南非洲地区。人乳头瘤病毒（HPV）被认为是一种潜在的致病因素，但没有确凿的证据。本综述涵盖了 HIV 感染者（PLWH）中结膜癌症的流行病学、诊断和治疗的最新证据。
在撒哈拉以南非洲，HIV 感染占结膜鳞状细胞癌的 33%。尽管已经证明免疫缺陷对结膜癌症风险的影响，但 HPV 在结膜癌症发展中的作用仍不清楚。生物标志物，如 p16 蛋白，并不总是表明 HPV 感染。爱泼斯坦-巴尔病毒（EBV）可能是结膜癌症发展中的另一种潜在的传染性病原体。有一些证据表明，PLWH 治疗后结膜癌症复发的可能性增加，转移的概率也增加。
免疫缺陷增加了 PLWH 发生结膜癌症的风险。应鼓励对 PLWH 进行结膜癌症的症状筛查。对 HPV 参与的研究应继续作为优先事项，同时也应考虑 EBV 作为另一种有意义的病原体。应考虑更多的 PLWH 治疗方式的研究。
