RESUMO
A record-linkage study was carried out between the Italian AIDS Registry and 24 Italian cancer registries to compare cancer excess among persons with HIV/AIDS (PWHA) before and after the introduction of highly active antiretroviral therapy (HAART) in 1996. Standardised incidence ratios (SIR) were computed in 21951 AIDS cases aged 16-69 years reported between 1986 and 2005. Of 101 669 person-years available, 45 026 were after 1996. SIR for Kaposi sarcoma (KS) and non-Hodgkin lymphoma greatly decreased in 1997-2004 compared with 1986-1996, but high SIRs for KS persisted in the increasingly large fraction of PWHA who had an interval of <1 year between first HIV-positive test and AIDS diagnosis. A significant excess of liver cancer (SIR=6.4) emerged in 1997-2004, whereas the SIRs for cancer of the cervix (41.5), anus (44.0), lung (4.1), brain (3.2), skin (non-melanoma, 1.8), Hodgkin lymphoma (20.7), myeloma (3.9), and non-AIDS-defining cancers (2.2) were similarly elevated in the two periods. The excess of some potentially preventable cancers in PWHA suggests that HAART use must be accompanied by cancer-prevention strategies, notably antismoking and cervical cancer screening programmes. Improvements in the timely identification of HIV-positive individuals are also a priority in Italy to avoid the adverse consequences of delayed HAART use.
Assuntos
Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Síndrome da Imunodeficiência Adquirida/epidemiologia , Terapia Antirretroviral de Alta Atividade , Neoplasias/epidemiologia , Neoplasias/etiologia , Síndrome da Imunodeficiência Adquirida/complicações , Adolescente , Adulto , Idoso , Feminino , HIV-1 , Humanos , Incidência , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Fatores de Risco , Adulto JovemRESUMO
Following the findings of some studies that have found the presence of Hg, HCB and PCBs in fish from the bay of Augusta and showed a strong association between the consumption of local fish and the increased risk of children born malformed among women of the same city, the authors, in collaboration with the judicial authorities, have initiated a study on the tracking of these substances in biological tissues of mothers exposed to risk of contamination because resident in the Syracusan industrial area. The study showed differences in excess, and statistically significant, among mothers of Augusta respect to a sample of Controls selected in another Sicilian region not exposed to the same risk of contamination, thereby reinforcing the idea that some substances from industrial source found in the environment and in the body of the mothers of Augusta have been able to contribute to the higher incidence of congenital malformations and abortions in the examined region, and leading a company petrochemicals to recognize the families of born malformed an economic compensation.