Increasing Deaths Due to Malignancy in HIV＋ Patients is Associated with Integrase Inhibitor Therapy
增加死于恶性肿瘤在艾滋病患者中伴有整合酶抑制剂治疗作者机构：Division of lnfectious Disease Hofstra North Shore-LIJ School of Medicine Manhasset NY 11030 USA The Feinstein Institute for Medical Research Manhasset NY 11030 USA Department of Biochemistry and Molecular Biophysics College of Physicians and Surgeons Columbia University New York NY10032 USA
出 版 物：《Journal of Health Science》 (健康科学（英文版）)
年 卷 期：2014年第2卷第5期
页 面：240-247页
学科分类：12[管理学] 1204[管理学-公共管理] 120402[管理学-社会医学与卫生事业管理(可授管理学、医学学位)] 1004[医学-公共卫生与预防医学(可授医学、理学学位)] 10[医学]
主 题：HIV, malignancy, integrase inhibitors, CD4 count, viral load, vitamin D, mortality, raltegravir.
摘 要：Despite reductions in AIDS-related deaths, registries show HIV＋ patients are still dying at a younger age than HIV-peers. Although overall mortality has declined in this population, a growing percent of deaths are due to malignancy. Since the data demonstrating the growing percentage of deaths due to malignancy in the HIV＋ population is derived from registries, the study explores whether the subset dying from malignancy has particular characteristics that can be seen in a well-characterized cohort. In the well-characterized HIV＋ cohort, the percentage of deaths due to cancer was seen to increase over four years （2010-2013） from 21% to 24% to 38% to 40%. The mean CD4-count of those who died from malignancy was 252＋/-42 and 333＋/-36 in patients with death from other causes. The viral load was not suppressed in 26% of patients dying from malignancy. Of patients on integrase inhibitor therapy, 48% of deaths were due to malignancy while in patients not on this therapy, 10% of deaths were due to malignancy （relative risk = 4.8）. In HIV＋ patients, a low CD4-count, failure to achieve viral suppression, and use of integrase inhibitors were associated with malignancy as the cause of death. The association of a specific therapy, integrase inhibition, with malignancy is seen in the study.
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