Darvishian Maryam, Butt Zahid A, Wong Stanley, Yoshida Eric M, Khinda Jaskaran, Otterstatter Michael, Yu Amanda, Binka Mawuena, Rossi Carmine, McKee Geoff, Pearce Margo, Alvarez Maria, Wong Jason, Cook Darrel, Grennan Troy, Buxton Jane, Tyndall Mark, Woods Ryan, Krajden Mel, Bhatti Parveen, Janjua Naveed Z
BC Cancer Research Centre, 675 W 10th Ave, Vancouver, BC V5Z 1L3, Canada.
School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.
Ther Adv Med Oncol. 2021 Feb 11;13:1758835921992987. doi: 10.1177/1758835921992987. eCollection 2021.
Studies of the impact of hepatitis C virus (HCV), hepatitis B virus (HBV) and HIV mono and co-infections on the risk of cancer, particularly extra-hepatic cancer, have been limited and inconsistent in their findings.
In the British Columbia Hepatitis Testers Cohort, we assessed the risk of colorectal, liver, and pancreatic cancers in association with HCV, HBV and HIV infection status. Using Fine and Gray adjusted proportional subdistribution hazards models, we assessed the impact of infection status on each cancer, accounting for competing mortality risk. Cancer occurrence was ascertained from the BC Cancer Registry.
Among 658,697 individuals tested for the occurrence of all three infections, 1407 colorectal, 1294 liver, and 489 pancreatic cancers were identified. Compared to uninfected individuals, the risk of colorectal cancer was significantly elevated among those with HCV (Hazard ration [HR] 2.99; 95% confidence interval [CI] 2.55-3.51), HBV (HR 2.47; 95% CI 1.85-3.28), and HIV mono-infection (HR 2.30; 95% CI 1.47-3.59), and HCV/HIV co-infection. The risk of liver cancer was significantly elevated among HCV and HBV mono-infected and all co-infected individuals. The risk of pancreatic cancer was significantly elevated among individuals with HCV (HR 2.79; 95% CI 2.01-3.70) and HIV mono-infection (HR 2.82; 95% CI 1.39-5.71), and HCV/HBV co-infection.
DISCUSSION/CONCLUSION: Compared to uninfected individuals, the risk of colorectal, pancreatic and liver cancers was elevated among those with HCV, HBV and/or HIV infection. These findings highlight the need for targeted cancer prevention and diligent clinical monitoring for hepatic and extrahepatic cancers in infected populations.
关于丙型肝炎病毒（HCV）、乙型肝炎病毒（HBV）和HIV单一感染及合并感染对癌症风险，尤其是肝外癌症风险影响的研究，其结果一直有限且不一致。
在不列颠哥伦比亚省肝炎检测队列中，我们评估了与HCV、HBV和HIV感染状况相关的结直肠癌、肝癌和胰腺癌风险。使用Fine和Gray调整后的比例亚分布风险模型，我们评估了感染状况对每种癌症的影响，并考虑了竞争死亡风险。癌症发生情况通过不列颠哥伦比亚癌症登记处确定。
在对658,697名个体进行的所有三种感染检测中，共识别出1407例结直肠癌、1294例肝癌和489例胰腺癌。与未感染个体相比，HCV感染者（风险比[HR] 2.99；95%置信区间[CI] 2.55 - 3.51）、HBV感染者（HR 2.47；95% CI 1.85 - 3.28）、HIV单一感染者（HR 2.30；95% CI 1.47 - 3.59）以及HCV/HIV合并感染者患结直肠癌的风险显著升高。HCV和HBV单一感染者以及所有合并感染者患肝癌的风险显著升高。HCV感染者（HR 2.79；95% CI 2.01 - 3.70）、HIV单一感染者（HR 2.82；95% CI 1.39 - 5.71）以及HCV/HBV合并感染者患胰腺癌的风险显著升高。
讨论/结论：与未感染个体相比，HCV、HBV和/或HIV感染者患结直肠癌、胰腺癌和肝癌的风险升高。这些发现凸显了在感染人群中进行针对性癌症预防以及对肝癌和肝外癌症进行勤勉临床监测的必要性。
