Sigel Keith, Yu Ryan, Chiao Elizabeth, Deshmukh Ashish, Leapman Michael S
Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Department of Epidemiology, University of Texas, MD Anderson Cancer Center, Houston, Texas.
Curr Opin Infect Dis. 2025 Feb 1;38(1):10-17. doi: 10.1097/QCO.0000000000001076. Epub 2024 Nov 28.
Prostate cancer burden has been rising among people with HIV (PWH), yet it remains understudied in the context of HIV infection. The objective of this review article is to summarize contemporary information on the burden, risk, and outcomes of prostate cancer for people living with HIV.
Despite a lower apparent incidence of prostate cancer in early studies for PWH compared to uninfected persons, this malignancy is now likely to be the most common tumor for US PWH. Tumor characteristics and stage appear to have limited differences by HIV status. The optimal approach to early detection of prostate cancer remains controversial, and there are little HIV-specific data surrounding screening. Prostate cancer outcomes may have been worse for PWH in the early antiretroviral era but may have improved in more recent years.
Prostate cancer is an increasingly common clinical issue for PWH. Lower than expected incidence rates in the early ART-era may be increasing, and oncologic outcomes may also be improving. Treatment tolerability is still a key question for this patient group. Given the clinical and biological complexity of chronic HIV infection, strategies for both early detection and treatment will need continued evaluation specifically in the setting of HIV.
前列腺癌在HIV感染者(PWH)中的负担一直在上升,但在HIV感染背景下仍未得到充分研究。这篇综述文章的目的是总结关于HIV感染者前列腺癌负担、风险和结局的当代信息。
尽管早期研究显示PWH的前列腺癌发病率明显低于未感染者,但这种恶性肿瘤现在可能是美国PWH最常见的肿瘤。肿瘤特征和分期似乎因HIV状态而异。前列腺癌早期检测的最佳方法仍存在争议,且围绕筛查的HIV特异性数据很少。在抗逆转录病毒治疗早期,PWH的前列腺癌结局可能较差,但近年来可能有所改善。
前列腺癌是PWH日益常见的临床问题。早期抗逆转录病毒治疗时代低于预期的发病率可能正在上升,肿瘤学结局也可能正在改善。治疗耐受性仍是该患者群体的关键问题。鉴于慢性HIV感染的临床和生物学复杂性,早期检测和治疗策略需要在HIV背景下持续评估。