Bernstein L, Hamilton A S
Department of Preventive Medicine, University of Southern California School of Medicine, Los Angeles 90033.
Curr Opin Oncol. 1993 Sep;5(5):822-30. doi: 10.1097/00001622-199309000-00009.
Immunosuppression resulting from HIV infection does not explain the unique distribution of Kaposi's sarcoma across risk groups. A majority of cases occur among homosexual men, particularly those with oral-anal contact, those with sexual contacts in high-risk cities, and those frequently use nitrite inhalants, suggesting a currently unidentified etiologic cofactor. Risk of non-Hodgkin's lymphoma among HIV-infected persons continues to increase over time. Because all HIV-infected groups are at high risk of non-Hodgkin's lymphoma, environmental cofactors may be less important in the disease's etiology. Because data on risk factors for AIDS-related non-Hodgkin's lymphoma are limited, further studies are needed. Cohort studies suggested that the risk of Hodgkin's disease is greater among HIV-infected persons; however, the number of cases reported has been small. Hodgkin's disease occurring among HIV-infected persons is more aggressive than and differs in presentation from that among noninfected persons. The addition of invasive cervical cancer to the US Centers for Disease Control definition of AIDS is based on data showing that HIV-infected women have a high prevalence of cervical disease. Although no conclusions can yet be drawn regarding the temporal relationship of cervical disease and HIV infection, there is evidence of a direct relationship between the degree of HIV-induced immunosuppression and the extent of cervical disease. Other cancers are being diagnosed among AIDS patients, and monitoring of the risk of solid tumors among various cohorts of high-risk and HIV-infected persons continues.
由HIV感染导致的免疫抑制并不能解释卡波西肉瘤在不同风险群体中的独特分布情况。大多数病例发生在男同性恋者中，尤其是那些有口交肛交行为的人、在高危城市有性接触的人以及经常使用亚硝酸酯吸入剂的人，这表明存在一种目前尚未明确的病因协同因素。随着时间的推移，HIV感染者中非霍奇金淋巴瘤的风险持续增加。由于所有HIV感染群体都有患非霍奇金淋巴瘤的高风险，环境协同因素在该疾病的病因中可能不太重要。由于与艾滋病相关的非霍奇金淋巴瘤危险因素的数据有限，需要进一步开展研究。队列研究表明，HIV感染者患霍奇金病的风险更高；然而，报告的病例数量较少。HIV感染者中发生的霍奇金病比未感染者中的更具侵袭性，且临床表现有所不同。将侵袭性宫颈癌纳入美国疾病控制中心对艾滋病的定义是基于数据显示HIV感染女性宫颈疾病的患病率很高。虽然目前还无法就宫颈疾病与HIV感染的时间关系得出结论，但有证据表明HIV诱导的免疫抑制程度与宫颈疾病的程度之间存在直接关系。在艾滋病患者中还诊断出了其他癌症，并且对各类高危人群和HIV感染人群中实体瘤风险的监测仍在继续。
