Chiao Elizabeth Y, Coghill Anna, Kizub Darya, Fink Valeria, Ndlovu Ntokozo, Mazul Angela, Sigel Keith
Department of Epidemiology, Division of Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of General Oncology, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Cancer Epidemiology Program, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA; Center for Immunization and Infection Research in Cancer, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
Lancet Oncol. 2021 Jun;22(6):e240-e253. doi: 10.1016/S1470-2045(21)00137-6.
Non-AIDS-defining cancers are a growing source of morbidity for people with HIV globally. Although people living with HIV have a disproportionately increased risk of developing virally mediated cancers, cancer burden for common non-AIDS-defining cancers that are not virally associated and are linked to ageing, such as prostate cancer, is becoming higher than for virally mediated cancers. Ageing, behavioural, and HIV-specific factors drive the incidence and affect the outcomes of non-AIDS-defining cancers, presenting different challenges for addressing global morbidity and mortality from non-AIDS-defining cancer. Although large population-based studies have shown that people living with HIV with non-AIDS-defining cancers have poorer cancer outcomes than do people without HIV, current guidelines emphasise that people living with HIV with non-AIDS-defining cancers should receive standard, guideline-based treatment, and infectious disease and oncology providers should work closely to address potential drug interactions between antiretroviral therapy and antineoplastic treatment. Most trials target preventive measures focusing on non-AIDS-defining cancers. However, treatment trials for the optimal management of people living with HIV and non-AIDS-defining cancer, including interventions such as immunotherapies, are needed to improve non-AIDS-defining cancer outcomes.
对于全球感染艾滋病毒的人来说，非艾滋病定义的癌症正日益成为发病的一个来源。尽管感染艾滋病毒的人患病毒介导癌症的风险不成比例地增加，但与衰老相关、非病毒介导的常见非艾滋病定义癌症（如前列腺癌）的癌症负担正高于病毒介导的癌症。衰老、行为和艾滋病毒特异性因素推动了非艾滋病定义癌症的发病率，并影响其预后，给应对非艾滋病定义癌症导致的全球发病和死亡带来了不同挑战。尽管基于大规模人群的研究表明，患有非艾滋病定义癌症的艾滋病毒感染者的癌症预后比未感染艾滋病毒的人更差，但当前指南强调，患有非艾滋病定义癌症的艾滋病毒感染者应接受基于指南的标准治疗，传染病和肿瘤学医疗服务提供者应密切合作，以应对抗逆转录病毒疗法和抗肿瘤治疗之间潜在的药物相互作用。大多数试验针对侧重于非艾滋病定义癌症的预防措施。然而，需要开展针对艾滋病毒感染者和非艾滋病定义癌症最佳管理的治疗试验，包括免疫疗法等干预措施，以改善非艾滋病定义癌症的预后。
