Department of Biochemistry, University of Washington, Box 357236, Seattle, WA, 98195, USA.
Department of Global Health, University of Washington, Seattle, WA, USA.
Curr HIV/AIDS Rep. 2021 Apr;18(2):105-116. doi: 10.1007/s11904-021-00542-5. Epub 2021 Feb 2.
The relationship between antiretroviral therapy (ART) and cancer treatment outcomes among people living with HIV (PLWH) in low- and middle-income countries (LMICs) is complex and poorly understood for many cancers. We aimed to summarize existing evidence from LMICs regarding the benefit of ART on cancer treatment-related outcomes.
We included twelve observational studies that reported associations between ART status and cancer treatment outcomes among HIV-positive patients in LMICs. Most confirmed ART was associated with improved cancer treatment outcomes. Heterogeneity in cancers under study, outcome measurement, categorization of ART status, and reporting of HIV-related immune function made formal comparison between studies untenable. Where evaluated, ART generally has a positive effect on cancer outcomes in people with HIV in LMICs. However, there remains a substantial gap in the literature regarding the impact of ART on treatment outcomes for most cancer types. Future research should focus on the optimal timing and integration of ART and cancer treatment for PLWH with strategies applicable to constrained-resource settings.
综述目的:在中低收入国家(LMICs),抗逆转录病毒疗法(ART)与艾滋病毒感染者(PLWH)癌症治疗结果之间的关系对于许多癌症而言较为复杂,且了解甚少。我们旨在总结来自 LMICs 的现有证据,了解 ART 对癌症治疗相关结果的益处。
最新发现:我们纳入了 12 项观察性研究,报告了 ART 状态与 LMIC 中 HIV 阳性患者癌症治疗结果之间的关联。大多数经确认的 ART 与改善癌症治疗结果相关。研究对象中癌症的异质性、结果测量、ART 状态分类以及 HIV 相关免疫功能的报告使得对研究之间进行正式比较变得不可行。在评估的情况下,ART 通常对 LMIC 中 HIV 感染者的癌症结局具有积极影响。然而,ART 对大多数癌症类型的治疗结果的影响在文献中仍然存在很大差距。未来的研究应侧重于针对资源有限环境中具有策略性的 PLWH 制定 ART 和癌症治疗的最佳时机和整合。