Περίληψη:
Objective. - To determine the types and rates of cancers occurring in
excess in the presence of infection with the human immunodeficiency
virus type 1 (HIV-1).
Design. - Cohort analytic study of HIV-infected and HIV-uninfected
subjects followed for up to 12 years. Setting. - Fifteen hemophilia
treatment centers.
Patients. - A total of 1701 patients with hemophilia, of whom 1065
(63%) were HIV-1 seropositive.
Main Outcome Measures. -Morphologic classification and incidence rates
of cancers.
Main Results. - The incidence of non-Hodgkin’s lymphoma after HIV
seroconversion averaged 0.15 case per 100 person-years (95% confidence
interval [Cl], 0.08 to 0.25) and rose exponentially with increasing
duration of HIV infection. Although the greatest absolute risk of
lymphoma was in the oldest age group, the relative increase compared
with general population rates was 38-fold in subjects 10 to 39 years old
and 12-fold in older subjects (P <.05). The CD4+ T-lymphocyte levels
for lymphoma cases were similar to HIV-positive subjects without the
acquired immunodeficiency syndrome (AIDS) who had been infected for the
same length of time. The incidence of Kaposi’s sacroma was increased
200-fold (95% Cl, 20 to 700). The incidence of cancers other than
non-Hodgkin’s lymphoma and Kaposi’s sarcoma were not increased in the
HIV-positive subjects (ratio of observed to expected cases, 0.9 [95%
Cl, 0.4 to 1.9]). The HIV-negative subjects had no significant increase
in cancer incidence.
Conclusions. - HIV infection has restricted effects on cancer incidence
that are only partly explained by immunosuppression. Paradoxically,
improvements in therapy of HIV infection that prolong survival may lead
to further increases in HIV-associated lymphoma.
Συγγραφείς:
RABKIN, CS
HILGARTNER, MW
HEDBERG, KW
ALEDORT, LM and
HATZAKIS, A
EICHINGER, S
EYSTER, ME
WHITE, GC
KESSLER,
CM
LEDERMAN, MM
DEMOERLOOSE, P
BRAY, GL
COHEN, AR and
ANDES, WA
MANCOJOHNSON, M
SCHRAMM, W
KRONER, BL and
BLATTNER, WA
GOEDERT, JJ
