| 王婷婷,汪剡灵,王雅婷,王良友,魏鑫晨,陈潇潇,陈泰霖,任吉元,刘星,林海江,何纳.浙江省台州市HIV感染者恶性肿瘤发病率及影响因素的回顾性队列研究[J].中华流行病学杂志,2025,46(8):1372-1378 |
| 浙江省台州市HIV感染者恶性肿瘤发病率及影响因素的回顾性队列研究 |
| A retrospective cohort study on the incidence and influencing factors of malignancies among HIV-infected patients in Taizhou, Zhejiang Province |
| 收稿日期:2025-04-02 出版日期:2025-08-21 |
| DOI：10.3760/cma.j.cn112338-20250402-00211 |
| 中文关键词: HIV感染者 恶性肿瘤 标化发病率 回顾性队列 |
| 英文关键词: HIV-infected patients Malignant tumor Standardized incidence ratios Retrospective cohort |
| 基金项目:台州市高层次人才特殊支持计划（TZ2022-2）；上海市加强公共卫生体系建设行动计划重点学科建设项目（GWVI-11.1-05，GWVI-11.1-03） |
| 作者 | 单位 | E-mail | | 王婷婷 | 台州市疾病预防控制中心(台州市卫生监督所), 台州 318000 | | | 汪剡灵 | 台州市疾病预防控制中心(台州市卫生监督所), 台州 318000 | | | 王雅婷 | 台州市疾病预防控制中心(台州市卫生监督所), 台州 318000 | | | 王良友 | 台州市疾病预防控制中心(台州市卫生监督所), 台州 318000 | | | 魏鑫晨 | 台州市疾病预防控制中心(台州市卫生监督所), 台州 318000 | | | 陈潇潇 | 复旦大学公共卫生学院流行病学教研室, 上海 200032 | | | 陈泰霖 | 复旦大学公共卫生学院流行病学教研室, 上海 200032 | | | 任吉元 | 复旦大学公共卫生学院流行病学教研室, 上海 200032 | | | 刘星 | 复旦大学公共卫生学院流行病学教研室, 上海 200032 | | | 林海江 | 台州市疾病预防控制中心(台州市卫生监督所), 台州 318000 | fudanlhj@qq.com | | 何纳 | 复旦大学公共卫生学院流行病学教研室, 上海 200032 | nhe@fudan.edu.cn |
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| 中文摘要: |
| 目的 分析浙江省台州市HIV感染者的恶性肿瘤发病情况及影响因素。方法 资料来源于中国疾病预防控制信息系统和台州市慢性病信息管理系统，采用回顾性队列研究设计，研究对象为2005-2023年户籍地为台州市、参与随访的HIV感染者，随访截至2024年12月31日。描述HIV感染者恶性肿瘤的标化发病率（SIR），采用Cox比例风险回归模型分析恶性肿瘤发病的影响因素。结果 纳入3 593例HIV感染者，292例共患恶性肿瘤。其中艾滋病定义恶性肿瘤和非艾滋病定义恶性肿瘤的比例分别为12.33%（36/292）和87.67%（256/292），确证前患病和确证后患病的比例分别为43.49%（127/292）和56.51%（165/292）。HIV感染者纳入随访队列3 466例，累计随访24 968.59人年。HIV感染者恶性肿瘤的粗发病率为658.46/10万（SIR=1.89，95%CI： 1.61~2.20），且SIR随时间的增加呈上升趋势。Cox比例风险回归模型分析结果显示，年龄45~59岁和≥60岁（aHR=2.58，95%CI：1.26~5.28； aHR=5.00，95%CI：2.38~10.51）的HIV感染者更有可能发生恶性肿瘤；高中及以上文化程度（aHR=0.52，95%CI：0.29~0.95）、首次CD4+T淋巴细胞/CD8+T淋巴细胞计数比值≥0.5（aHR=0.52，95%CI： 0.28~0.97）的HIV感染者发生恶性肿瘤的可能性更低。结论 2005-2023年台州市HIV感染者恶性肿瘤发病率较普通人群高，且多为非艾滋病定义恶性肿瘤，需要在HIV感染者管理中加强恶性肿瘤的早期筛查诊断。 |
| 英文摘要: |
| Objective To analyze the incidence and risk factors of malignant tumors among HIV-infected patients in Taizhou, Zhejiang Province. Methods The data were collected from the China Information System for Disease Control and Prevention and the Taizhou Chronic Disease Information Management System. A retrospective cohort study design was used. The subjects were HIV-infected patients who had their household registration in Taizhou from 2005 to 2023 and participated in the follow-up. The observation period was until December 31, 2024. The standardized incidence ratios (SIR) of malignant tumors among HIV-infected patients were analyzed. Cox proportional hazards regression model was used to analyze the influencing factors of malignant tumor incidence. Results A total of 3 593 HIV-infected patients were included, of whom 292 had malignant tumors. The proportions of AIDS-defining malignancies and non-AIDS-defining malignancies were 12.33% (36/292) and 87.67% (256/292), respectively. The proportion of malignant tumors before and after AIDS confirmation was 43.49% (127/292) and 56.51% (165/292), respectively. 3 466 HIV-infected patients were included in the follow-up cohort, with a total follow-up of 24 968.59 person-years. The incidence rate of malignant tumors in patients with HIV infection was 658.46 per 100 000 (SIR=1.89, 95%CI: 1.61-2.20). The SIR of malignant tumors showed an upward trend with the increase of time. The results of Cox proportional hazards regression model analysis showed that HIV-infected patients in the age groups of 45-59 and ≥60 years (aHR=2.58, 95%CI: 1.26-5.28; aHR=5.00, 95%CI: 2.38-10.51) were more likely to develop malignant tumors. HIV-infected patients with an educational level of senior high school or above (aHR=0.52, 95%CI: 0.29-0.95) and those in the first CD4+T lymphocyte/CD8+T lymphocyte count ratio ≥0.5 (aHR=0.52, 95%CI: 0.28-0.97) were less likely to develop malignant tumors. Conclusions From 2005 to 2023, the incidence of malignant tumors among HIV-infected people in Taizhou was higher than that of the general population, and most of them were non-AIDS-defining malignancies. It is necessary to strengthen the early screening and diagnosis of malignant tumors among HIV-infected patients. |
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