人类免疫缺陷病毒感染患者继发恶性肿瘤的危险因素分析

Risk factors for secondary malignant tumors in patients infected with human immunodeficiency virus

目的探讨人类免疫缺陷病毒(HIV)感染患者继发恶性肿瘤的危险因素。方法选取2010年1月至2020年1月间西安疾病预防控制中心确诊的159例HIV感染者,合并恶性肿瘤者78例,单纯HIV感染者81例,对合并恶性肿瘤组以及单纯HIV感染组的临床资料进行回顾性分析。结果78例HIV感染合并恶性肿瘤患者中,涉及到的恶性肿瘤类型中,占比最多的为卡波西肉瘤、淋巴瘤和皮肤癌。两组患者年龄分布中,20~40岁、40~50岁年龄段,单纯HIV感染组比例显著高于合并恶性肿瘤组,在50岁以上年龄段,合并恶性肿瘤组显著高于单纯HIV感染组,差异均有统计学意义(均P<0.05)。单纯HIV感染患者和合并恶性肿瘤患者的职业分布情况方面,农民,工人,干部,无业的分布比例,差异无统计学意义(P>0.05)。合并恶性肿瘤组在CD4^+、CD4^+/CD8^+、自然杀伤细胞方面显著低于单纯HIV感染组,差异有统计学意义(P<0.05)。结论年龄、免疫功能紊乱增加了HIV感染者并发恶性肿瘤的风险,对于高危人群,应该尽早给予干预,逆转HIV造成的免疫功能紊乱问题,帮助患者重建免疫功能,延长患者生存期,提升患者生活质量。

Objective To explore the risk factors for secondary malignant tumors in patients infected with human immunodeficiency virus(HIV).Methods From January 2010 to January 2020,159 HIVinfected patients who had been screened positively at Xi’an Eighth Hospital and confirmed by our Center for Disease Prevention and Control were selected as the research subjects.Among them,78 patients also had malignant tumors and 81 patients were sheer HIV-infected.The clinical data of the two groups were retrospectively analyzed.Results Among patients with HIV infection complicated with malignant tumors,nonHodgkin’s lymphoma and cervical cancer accounted for the largest proportion.In terms of age distribution,the proportion of simple HIV infection was significantly higher than that of HIV infection complicated with malignant tumors between the ages of 20 and 40 years old and between 40 and 50 years old(all P<0.05).However,in patients above 50 years old,the proportion of HIV infection complicated with malignant tumors was significantly higher than that of simple HIV infection(P<0.05).There was no statistically significant difference in the ratio of occupational distribution such as farmers,workers,cadres,and the unemployed between the two groups(P>0.05).The levels of CD4^+,CD4^+/CD8^+,and natural killer(NK)cells were significantly lower in patients with HIV infection complicated with malignant tumors than patients with simple HIV infection(P<0.05).Conclusion Age and disorders of immune function increase the risk for malignant tumors in HIV-infected patients.For high-risk population,intervention should be given as soon as possible to reverse the immune dysfunction caused by HIV,help patients rebuild their immune function,prolong their survival,and improve their quality of life.