A Meta-Analysis of the Incidence of Non-AIDS Cancers in HIV-Infected Individuals

作者：Shiels Meredith S^*; Cole Stephen R; Kirk Gregory D; Poole Charles

来源：JAIDS: Journal of Acquired Immune Deficiency Syndromes , 2009, 52(5): 611-622.

DOI：10.1097/qai.0b013e3181b327ca

• AIDS
• cancer
• epidemiology
• HIV
• meta-analysis

Objective: To estimate summary standardized incidence ratios (SIRS) of non-AIDS cancers among HIV-infected individuals compared with general population rates overall and stratified by gender, AIDS, and highly active antiretroviral therapy (HAART) era.
Design: A meta-analysis using SIRS from 18 studies of non-AIDS cancer in HIV-infected individuals.
Methods: SIRS for non-AIDS cancers in HIV-infected individuals and 95% confidence limits (CLs) were abstracted from each study. Random effects meta-analyses were used to estimate summary SIRS. Modifications by gender, AIDS, and HAART era were estimated with meta-regression.
Results: Four thousand seven hundred ninety-seven non-AIDS cancers occurred among 625,716 HIV-infected individuals. SIRS for several cancers were elevated., In particular, cancers associated with infections, such as anal (SIR = 28; 95% CL 21 to 35), liver (SIR = 5.6; 95% CL 4.0 to 7.7), and Hodgkin lymphoma (SIR = 11; 95% CL 8.8 to 15) and smoking, such as lung (SIR = 2.6; 95% CL 2.1 to 3.1), kidney (SIR = 1.7; 95% CL 1.3 to 2.2), and laryngeal (SIR = 1.5; 95% CL 1.1 to 2.0). AIDS was associated with greater SIRS for Hodgkin lymphoma, leukemia, lung, brain, and all non-AIDS cancers combined.
Conclusions: HIV-infected individuals may be at an increased risk of developing non-AIDS cancers, particularly those associated with infections and smoking. An association with advanced immune suppression was suggested for certain cancers.

• 出版日期2009-12-15