ヒト免疫不全ウイルスに関連する小児性悪性腫瘍のリスク要因
Brad H Pollock1, Hal B Jenson, Charles T Leach
1Children's Cancer Research Institute, Center for Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio, TX 78229-3900, USA. bpollock@uthscsa.edu
JAMA
|May 15, 2003
まとめ
高いエプスタイン・バーウイルス (EBV) ウイルス負荷は,ヒト免疫不全ウイルス (HIV) を感染した子供,特にCD4細胞数が多い子供のがんリスクの増加と関連しています. 感染経路やジドボウジン使用などの他の要因は,有意な危険因子ではなかった.
科学分野:
- 小児腫瘍学 小児腫瘍学
- 感染症 感染症は感染症です.
- 免疫学 免疫学とは
背景:
- 癌は,ヒト免疫不全ウイルス (HIV) 感染の子どもでより頻繁に発生します.
- この集団における悪性腫瘍の特定の臨床的,免疫的,およびウイルス性リスク因子は未確認のままである.
研究 の 目的:
- HIVに感染した子供の悪性腫瘍の危険因子を特定する.
- エプスタイン・バーウイルス (EBV) とHIV感染児の悪性腫瘍との関連を調査する.
- 小児のHIV関連悪性腫瘍におけるCD4細胞数と抗レトロウイルス治療の役割を評価する.
主な方法:
- 43人のHIV感染児の悪性腫瘍と,悪性腫瘍のない74人の対照群を対象としたマルチセンター症例対照研究.
- HIV感染の期間に基づいてマッチングした参加者は,1992年から1998年の間に登録されました.
- 人口統計,HIVの特徴,抗レトロウイルス治療,CD4細胞数,およびPCRと血清学を用いたコロナウイルス感染症 (EBV,サイトメガロウイルス,ヒトヘルペスウイルス6) を含むリスク要因の評価.
主要な成果:
- エプスタイン・バーウイルス (EBV) ウイルス負荷>50コピー/105PBMCは,CD4カウント≥200/μL (OR,11.33;P<.001) の子供のがんリスクと強く関連していました.
- この関連性は,CD4カウント <200/μL (OR,1.12;P=.99) の子供では観察されなかった.
- ジドフウジン療法とHIV感染経路は,有意な保護的またはリスク要因ではありませんでした.
結論:
- 高いEBVウイルス負荷は,HIVに感染した子供の悪性腫瘍発症と関連しており,その効果はCD4細胞数によって変化しています.
- 人口統計,感染経路,ジドウジンの使用は悪性腫瘍のリスクと関連していません.
- HIVに関連した小児性悪性腫瘍の病原性は,他の要因を明らかにするためにさらなる調査を必要とします.
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