Increased risk of non-AIDS-defining cancers in Asian HIV-infected patients: a long-term cohort study

被引：30

作者：

Nagata, Naoyoshi ^{[1
,2
]}

Nishijima, Takeshi ^{[3
]}

Niikura, Ryota ^{[4
]}

Yokoyama, Tetsuji ^{[5
]}

Matsushita, Yumi ^{[6
]}

Watanabe, Koji ^{[3
]}

Teruya, Katsuji ^{[3
]}

Kikuchi, Yoshimi ^{[3
]}

Akiyama, Junichi ^{[1
,2
]}

Yanase, Mikio ^{[1
,2
]}

Uemura, Naomi ^{[7
]}

Oka, Shinichi ^{[3
]}

Gatanaga, Hiroyuki ^{[3
]}

机构：

[1] Natl Ctr Global Hlth & Med, Dept Gastroenterol, Shinjuku Ku, 1-21-1 Toyama, Tokyo 1628655, Japan

[2] Natl Ctr Global Hlth & Med, Dept Hepatol, Shinjuku Ku, 1-21-1 Toyama, Tokyo 1628655, Japan

[3] Natl Ctr Global Hlth & Med, AIDS Clin Ctr, Shinjuku Ku, 1-21-1 Toyama, Tokyo 1628655, Japan

[4] Univ Tokyo, Grad Sch Med, Dept Gastroenterol, Bunkyo Ku, Tokyo 1138655, Japan

[5] Natl Inst Publ Hlth, Dept Hlth Promot, 2-3-6 Minami, Wako, Saitama 3510197, Japan

[6] Natl Ctr Global Hlth & Med, Dept Clin Res, Shinjuku Ku, 1-21-1 Toyama, Tokyo 1628655, Japan

[7] Natl Ctr Global Hlth & Med, Kohnodai Hosp, Dept Gastroenterol & Hepatol, 1-7-1 Kohnodai, Ichikawa, Chiba 2728516, Japan

来源：

BMC CANCER | 2018年 / 18卷

关键词：

Non-AIDS-defining malignancies; Gastric cancer; Colorectal cancer; Liver cancer; Lung cancer; All-cause mortality; Hepatitis viral infection; Highly active antiretroviral therapy; ACTIVE ANTIRETROVIRAL THERAPY; GASTRIC-CANCER; UNITED-STATES; GENERAL-POPULATION; VIRUS-INFECTION; JAPAN; IMMUNODEFICIENCY; MALIGNANCIES; PREVALENCE; PREVENTION;

D O I：

10.1186/s12885-018-4963-8

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

BackgroundData on the long-term risks of non-AIDS defining cancers (NADCs) are limited, especially in Asians. The incidence of NADCs may correlate with the epidemiological trend of cancers or oncogenic infection in each country, and thus the target cancers would be different between Western and Asian countries. We aimed to elucidate the incidence of NADCs and its predictive factors in Asian HIV-infected patients.MethodsSubjects were HIV-infected patients (n=1001) periodically followed-up for 9years on average. NADCs were diagnosed by histopathology and/ or imaging findings. Standardized incidence ratios (SIR) were calculated as the ratio of the observed to expected number of NADCs for comparison with an age-and sex-matched general population. Cox's proportional hazards model was used to estimate hazard ratios (HR).ResultsDuring the median follow-up of 9years, the 10-year cumulative incidence of NADCs was 6.4%.At NADC diagnosis, half of patients presented at age 40-59years and with advanced tumor stage. Compared with the age-and sex-matched general population, HIV-infected patients are at increased risk for liver cancer (SIR, 4.7), colon cancer (SIR, 2.1), and stomach cancer (SIR, 1.8). In multivariate analysis, a predictive model for NADCs was developed that included age group (40-49, 50-59, 60-69, and70years), smoker, HIV infection through blood transmission, and injection drug use (IDU), and HBV co-infection. The c-statistic for the NADCs predictive model was 0.8 (95%CI, 0.8-0.9, P<0.001). The higher 10-year incidence rate of NADCs was associated with increasing prediction score.ConclusionsLiver and colon cancer risk was elevated in Asian HIV-infected individuals, similar to in Western populations, whereas stomach cancer risk was characteristically elevated in Asian populations. Half of Asian NADC patients were aged 40-59years and had advanced-stage disease at diagnosis. Periodic cancer screening may be warranted for high-risk subpopulations with smoking habit, HIV infection through blood transmission or IDU, and HBV co-infection, and screening should be started over 40years of age.

引用

页数：9

共 30 条

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