Institut Jules Bordet, Université Libre de Bruxelles (ULB), Boulevard de Waterloo, Bruxelles, Belgium.
EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas.
AIDS. 2021 Mar 15;35(4):605-618. doi: 10.1097/QAD.0000000000002810.
As women living with HIV (WLWH) become older, their risk of developing breast cancer increases. Nonetheless, literature is conflicting regarding tumor stage, distribution of subtypes and overall survival among WLWH vs. HIV-negative women with breast cancer. We assessed differences in clinicopathological characteristics and overall survival between these two groups.
Systematic review and meta-analysis using MEDLINE, Scopus, ISI Web of Knowledge, LILACS, SciELO and conference abstracts up to 1 January 2020. Cross-sectional/cohort studies comparing baseline characteristics (stage and/or subtypes) and/or overall survival of WLWH vs. HIV-negative women with breast cancer were included. We performed random-effects meta-analyses to estimate summary statistics and subgroup analyses according to region of the world.
Eighteen studies [4 from North America, 14 from sub-Saharan Africa (SSA)] were included, with 3174 WLWH and 2 394 598 HIV-negative women. WLWH from North America and SSA were more likely to present with stage III/IV disease compared with HIV-negative women - pooled odds ratio (pOR) 1.76 [95% confidence interval (CI):1.58-1.95] and pOR 1.23 (95% CI: 1.06-1.42), respectively. WLWH from SSA were also less likely to have estrogen receptor-positive/HER2-negative tumors (pOR 0.81; 95% CI: 0.66-0.99). After adjustment, WLWH had worse overall survival compared with HIV-negative women, both in North America [pooled adjusted hazard ratio (aHR) 2.45; 95% CI: 1.11-5.41] and SSA (aHR 1.43; 95% CI: 1.06-1.92).
Compared with HIV-negative women, WLWH are diagnosed with breast cancer at a more advanced stage and have a worse overall survival. These results should raise awareness regarding the detection and survival gap among WLWH with breast cancer and further studies are needed to decipher the reasons behind these disparities.
随着感染艾滋病毒的女性（WLWH）年龄的增长，她们患乳腺癌的风险增加。然而，关于 WLWH 与感染 HIV 阴性的乳腺癌女性之间的肿瘤分期、亚型分布和总体生存率，文献存在争议。我们评估了这两组之间的临床病理特征和总体生存率的差异。
系统检索 MEDLINE、Scopus、ISI Web of Knowledge、LILACS、SciELO 和截止到 2020 年 1 月 1 日的会议摘要，使用 MEDLINE、Scopus、ISI Web of Knowledge、LILACS、SciELO 和会议摘要进行综述和荟萃分析。纳入比较 WLWH 与感染 HIV 阴性的乳腺癌女性基线特征（分期和/或亚型）和/或总体生存率的横断面/队列研究。我们进行了随机效应荟萃分析，以根据世界区域估计汇总统计数据和亚组分析。
纳入了 18 项研究[来自北美 4 项，来自撒哈拉以南非洲（SSA）的 14 项]，共纳入 3174 名 WLWH 和 2394598 名感染 HIV 阴性的女性。与感染 HIV 阴性的女性相比，来自北美和 SSA 的 WLWH 更有可能患有 III/IV 期疾病 - 汇总优势比（pOR）为 1.76 [95%置信区间（CI）：1.58-1.95] 和 pOR 1.23（95% CI：1.06-1.42）。来自 SSA 的 WLWH 也较少有雌激素受体阳性/HER2 阴性肿瘤（pOR 0.81；95% CI：0.66-0.99）。调整后，与感染 HIV 阴性的女性相比，WLWH 的总体生存率更差，在北美（汇总调整后的危险比[aHR] 2.45；95% CI：1.11-5.41）和 SSA（aHR 1.43；95% CI：1.06-1.92）。
与感染 HIV 阴性的女性相比，WLWH 被诊断患有乳腺癌的分期更晚，总体生存率更差。这些结果应该引起人们对 WLWH 乳腺癌检测和生存差距的关注，需要进一步研究来破解这些差异背后的原因。
