一组人类免疫缺陷病毒血清转化者中的癌症发病率。意大利HIV血清转化研究组

Cancer incidence in a cohort of human immunodeficiency virus seroconverters. HIV Italian Seroconversion Study Group.

作者信息

Serraino D, Pezzotti P, Dorrucci M, Alliegro M B, Sinicco A, Rezza G

机构信息

Epidemiology Unit, Centro di Riferimento Oncologico, Aviano, Italy.

出版信息

Cancer. 1997 Mar 1;79(5):1004-8. doi: 10.1002/(sici)1097-0142(19970301)79:5<1004::aid-cncr17>3.0.co;2-5.

DOI:10.1002/(sici)1097-0142(19970301)79:5<1004::aid-cncr17>3.0.co;2-5

PMID:9041163

Abstract

BACKGROUND

In addition to Kaposi's sarcoma and non-Hodgkin's lymphomas, it has been postulated that human immunodeficiency virus (HIV) infection may increase the risk of other cancers. The aim of the current study was to compare incidence rates of cancer among individuals who seroconverted for HIV infection with the rates in the general population of Italy.

METHODS

This study is part of an ongoing cohort investigation conducted by the HIV Italian Seroconversion Study Group. The study has enrolled 1255 individuals (906 males and 349 females) between the ages of 20 and 49 years who are at risk for HIV infection and have had a documented negative HIV test followed by a positive test. For each individual, the midpoint in time between the negative and positive tests was used to estimate the seroconversion date. The person-years at risk for cancer were then computed from the midpoint date to the last follow-up date or to death, and the number of cases of cancer observed in the cohort was compared with the expected number, based on rates among the general population of the same age and gender. Standardized incidence ratios (SIR) and 95% confidence intervals (CI) were computed.

RESULTS

A total of 58 cases of cancer were observed in the cohort. In comparison with rates in the general population, Kaposi's sarcoma was 1051 times more frequent, and non-Hodgkin's lymphomas were 157 times more frequent. Hodgkin's disease was observed in 3 men (i.e., 38 times more often in the cohort of HIV seroconverters [95% CI, 8-111]), in particular among homosexual men (SIR = 103). One woman developed stomach carcinoma.

CONCLUSIONS

The findings of the current incidence study are in agreement with previous studies showing excesses of Kaposi's sarcoma and non-Hodgkin's lymphomas in HIV-positive individuals. In addition, the findings suggest an association of HIV infection with Hodgkin's disease. Whether Hodgkin's disease in HIV-infected individuals should be considered an AIDS-defining illness is a question that is worthy of attention.

摘要

背景

除卡波西肉瘤和非霍奇金淋巴瘤外，有假设认为人类免疫缺陷病毒（HIV）感染可能会增加患其他癌症的风险。本研究的目的是比较HIV感染血清转化者与意大利普通人群的癌症发病率。

方法

本研究是意大利HIV血清转化研究组正在进行的队列研究的一部分。该研究纳入了1255名年龄在20至49岁之间有HIV感染风险且有记录显示HIV检测从阴性转为阳性的个体（906名男性和349名女性）。对于每个个体，阴性和阳性检测之间的时间中点用于估计血清转化日期。然后从该中点日期到最后随访日期或死亡日期计算患癌的人年数，并将队列中观察到的癌症病例数与基于同年龄和性别的普通人群发病率的预期病例数进行比较。计算标准化发病率（SIR）和95%置信区间（CI）。