Abstract
Cancer is a leading cause of death among people living with HIV/AIDS (PLWHA). We conducted a systematic review and meta-analysis to evaluate prevalence of cancer risk factors among Chinese PLWHA based on 102 articles. Random effects meta-analysis was used to calculate the summary prevalence estimate (sPrev) and 95% confidence interval (CI) for each cancer risk factor by demographic group. Overall, the sPrev for each risk factor among Chinese PLWHA was: 41.1% (95% CI: 35.3–46.9%) for current smoking; 30.3% (95% CI: 23.3–37.4%) for current alcohol consumption; 24.4% (95% CI: 14.7–30.2%) for overweight and obesity; 12.5% (95% CI: 10.6–14.3%) for hepatitis B virus infection; 29.1% (95% CI: 23.6–34.5%) for hepatitis C virus infection; 33.9% (95% CI: 24.3–43.5%) for high-risk human papillomavirus infection from cervical samples and 78.6% (95% CI: 69.4–87.7%) from anal samples; 2.7% (95% CI: 0.7–4.7%) for Epstein-Barr virus (EBV) immunoglobulin M (IgM) positivity, 94.7% (95% CI: 90.7–98.8%) for EBV IgG positivity and 25.6% (95% CI: 12.4–38.8%) for EBV DNA positivity; 14.9% (95% CI: 12.4–17.4%) for human herpes virus 8 infection. The prevalence of major cancer risk factors was high among PLWHA in China, suggesting an urgent need for interventions to reduce cancer risk in this high-risk group.
Highlights
Active antiretroviral therapy (HAART) or combination antiretroviral therapy has drastically reduced mortality in people living with HIV/AIDS (PLWHA)[1,2,3]
We found that Chinese PLWHA had higher prevalence of smoking, alcohol consumption, and virus infections including hepatitis B virus (HBV), hepatitis C virus (HCV), human papillomavirus (HPV), Epstein-Barr virus (EBV) and human herpes virus 8 (HHV8), but had lower prevalence of overweight and obesity when compared with the HIV-negative participants from the same studies and the Chinese general population
The smoking prevalence is 53.3% for general Chinese men[117], while the summary prevalence estimate (sPrev) is even higher, reaching 63.2% for male PLWHA. Such elevated smoking prevalence in HIV infected people was found in independent Chinese studies comparing with HIV-negative participants[24, 35], and in a meta-analysis in western countries with lower smoking prevalence in general population[118]
Summary
Active antiretroviral therapy (HAART) or combination antiretroviral therapy (cART) has drastically reduced mortality in people living with HIV/AIDS (PLWHA)[1,2,3]. For PLWHA, cancer is one of the leading causes of death with higher incidence of both AIDS-defining cancers (ADCs) and non-AIDS-defining cancers (NADCs) compared with the general population[4,5,6,7,8]. The major risk factors associated with leading causes of cancer deaths include tobacco use (associated with lung, colorectal, stomach, and liver cancer), alcohol consumption (colorectal and liver cancer), overweight/obesity (breast and colorectal cancer), and viral infections (liver, stomach, and cervical cancer)[12, 13]. We conducted a meta-analysis among PLWHA in China to describe the prevalence of major cancer risk factors including tobacco smoking, alcohol consumption, overweight and obesity, and cancer-related viral infections such as hepatitis B virus (HBV), hepatitis C virus (HCV), human papillomavirus (HPV), Epstein-Barr virus (EBV) and human herpes virus 8 (HHV8). Prevalence estimates among Chinese PLWHA were compared with the general population or uninfected comparison groups from the same study when available
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