Cancer Epidemiology, Prevention & Control Program, Montefiore Einstein Cancer Center, Bronx, New York, USA.
Einstein-Rwanda Research and Capacity Building Program, Research for Development (RD Rwanda), Kigali, Rwanda.
Int J Cancer. 2024 Dec 15;155(12):2149-2158. doi: 10.1002/ijc.35091. Epub 2024 Aug 11.
Assessing the risk of cancer among people living with HIV (PLHIV) in the current era of antiretroviral therapy (ART) is crucial, given their increased susceptibility to many types of cancer and prolonged survival due to ART exposure. Our study aims to compare the association between HIV infection and specific cancer sites in Rwanda. Population-based cancer registry data were used to identify cancer cases in both PLHIV and HIV-negative persons. A probabilistic record linkage approach between the HIV and cancer registries was used to supplement HIV status ascertainment in the cancer registry. Associations between HIV infection and different cancer types were evaluated using unconditional logistic regression models. We performed several sensitivity analyses to assess the robustness of our findings and to evaluate the potential impact of different assumptions on our results. From 2007 to 2018, the cancer registry recorded 17,679 cases, of which 7% were diagnosed among PLHIV. We found significant associations between HIV infection and Kaposi's Sarcoma (KS) (adjusted odds ratio [OR]: 29.1, 95% CI: 23.2-36.6), non-Hodgkin lymphoma (NHL) (1.6, 1.3-2.0), Hodgkin lymphoma (HL) (1.6, 1.1-2.4), cervical (2.3, 2.0-2.7), vulvar (4.0, 2.5-6.5), penile (3.0, 2.0-4.5), and eye cancers (2.2, 1.6-3.0). Men living with HIV had a higher risk of anal cancer (3.1, 1.0-9.5) than men without HIV, but women living with HIV did not have higher risk than women without HIV (1.0, 0.2-4.3). Our study found that in an era of expanded ART coverage in Rwanda, HIV is associated with a broad range of cancers, particularly those linked to viral infections.
评估在抗逆转录病毒疗法（ART）时代感染艾滋病毒（HIV）人群（PLHIV）的癌症风险至关重要，因为他们由于接触 ART，患多种癌症的风险增加，且生存时间延长。我们的研究旨在比较 HIV 感染与卢旺达特定癌症部位之间的关联。我们使用基于人群的癌症登记数据来确定 PLHIV 和 HIV 阴性人群中的癌症病例。我们使用 HIV 和癌症登记处之间的概率记录链接方法来补充癌症登记处中 HIV 状态的确定。我们使用非条件逻辑回归模型评估 HIV 感染与不同癌症类型之间的关联。我们进行了几次敏感性分析，以评估我们研究结果的稳健性，并评估不同假设对我们结果的潜在影响。从 2007 年到 2018 年，癌症登记处记录了 17679 例病例，其中 7%是在 PLHIV 中诊断的。我们发现 HIV 感染与卡波济肉瘤（KS）（调整后的优势比[OR]：29.1，95%CI：23.2-36.6）、非霍奇金淋巴瘤（NHL）（1.6，1.3-2.0）、霍奇金淋巴瘤（HL）（1.6，1.1-2.4）、宫颈（2.3，2.0-2.7）、外阴（4.0，2.5-6.5）、阴茎（3.0，2.0-4.5）和眼部癌症（2.2，1.6-3.0）之间存在显著关联。与没有 HIV 的男性相比，感染 HIV 的男性患肛门癌的风险更高（3.1，1.0-9.5），但感染 HIV 的女性患肛门癌的风险并不高于没有 HIV 的女性（1.0，0.2-4.3）。我们的研究发现，在卢旺达扩大 ART 覆盖范围的时代，HIV 与广泛的癌症相关，特别是与病毒感染相关的癌症。
