Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
Department of Critical Care Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
Sci Rep. 2021 Dec 21;11(1):24353. doi: 10.1038/s41598-021-03672-3.
HIV-associated malignancies are responsible for morbidity and mortality increasingly in the era of potent antiretroviral therapy. This study aimed to investigate the distribution of HIV-associated malignancies among inpatients, the immunodeficiency and the effect of antiretroviral therapy (ART) on spectrum of HIV-associated malignancies. A total of 438 cases were enrolled from 2007 to 2020 in Beijing Ditan Hospital. Demographic, clinical and laboratory data, managements, and outcomes were collected and analyzed retrospectively. Of 438 cases, 433 were assigned to non-AIDS-defining cancers (NADCs) (n = 200, 45.7%) and AIDS-defining cancers (ADCs) (n = 233, 53.2%), 5 (1.1%) with lymphoma were not specified further. No significant change was observed in the proportion of NADCs and ADCs as time goes on. Of NADCs, lung cancer (n = 38, 19%) was the most common type, followed by thyroid cancer (n = 17, 8.5%). Patients with ADCs had lower CD4 counts(104.5/μL vs. 314/μL), less suppression of HIVRNA(OR 0.23, 95%CI 0.16-0.35) compared to those with NADCs. ART did not affect spectrum of NADCs, but affect that of ADCs (between patients with detectable and undetectable HIVRNA). ADCs remain frequent in China, and NADCs play an important role in morbidity and mortality of HIV positive population.
HIV 相关恶性肿瘤在高效抗逆转录病毒治疗时代导致发病率和死亡率日益增高。本研究旨在调查住院患者中 HIV 相关恶性肿瘤的分布、免疫缺陷以及抗逆转录病毒治疗（ART）对 HIV 相关恶性肿瘤谱的影响。本研究共纳入 2007 年至 2020 年在北京地坛医院就诊的 438 例患者。回顾性收集并分析了患者的人口统计学、临床和实验室数据、治疗方法和转归。438 例患者中，433 例被分配至非艾滋病定义性恶性肿瘤（NADCs）（n=200，45.7%）和艾滋病定义性恶性肿瘤（ADCs）（n=233，53.2%），5 例（1.1%）未进一步指定为淋巴瘤。随着时间的推移，NADCs 和 ADCs 的比例没有明显变化。在 NADCs 中，肺癌（n=38，19%）是最常见的类型，其次是甲状腺癌（n=17，8.5%）。与 NADCs 患者相比，ADCs 患者的 CD4 计数更低（104.5/μL vs. 314/μL），HIVRNA 抑制程度更低（比值比 0.23，95%可信区间 0.16-0.35）。ART 不影响 NADCs 的谱，但影响 ADCs 的谱（在可检测和不可检测 HIVRNA 的患者之间）。在中国，ADCs 仍然很常见，NADCs 在 HIV 阳性人群的发病率和死亡率中起着重要作用。
