目的:探讨联合抗反转录病毒治疗(combination antiretroviral therapy，cART)后艾滋病合并恶性肿瘤的流行趋势及发生风险的变化。方法:在国家艾滋病综合防治信息系统中筛选出2004年1月1日至2018年12月31日的湖北籍人类免疫缺陷病毒(human immunodeficiency virus，HIV)抗体阳性患者，分析其在不同cART阶段的艾滋病合并恶性肿瘤的肿瘤类型。以2013年湖北省或全国普通人群恶性肿瘤的发病率为对照，分析艾滋病人群中的恶性肿瘤标准化发病率(standardized incidence ratios，SIR)，并比较2004年至2013年与2014年至2018年不同cART阶段艾滋病合并恶性肿瘤的发生风险变化。统计学方法采用n χ2检验。n 结果:共纳入22 994例艾滋病患者，其中艾滋病合并恶性肿瘤323例。艾滋病相关恶性肿瘤(acquired immunodeficiency syndrome-defining cancers，ADC)以非霍奇金淋巴瘤(non-Hodgkin lymphoma，NHL)和宫颈癌常见，非艾滋病相关恶性肿瘤(non-acquired immunodeficiency syndrome-defining cancers，NADC)以肝癌、肺癌常见。与普通人群比较，艾滋病人群的总体恶性肿瘤发生风险并未增加(SIR＝1.06, n χ2＝0.62，n P＝0.426)，但卡波西肉瘤、NHL、霍奇金淋巴瘤、宫颈癌和除鼻咽癌外的头面部癌的发生风险显著升高(SIR＝834.09、9.65、13.33、5.22、2.94, n χ2＝11 747.27、625.54、56.65、184.21、13.66，均n P<0.01)，肺癌、结直肠肛门癌、胃癌和乳腺癌的发生风险显著降低(SIR＝0.33、0.36、0.43、0.45,n χ2＝33.43、12.84、9.01、7.21，均n P<0.05)。2014年至2018年宫颈癌、肝癌和结直肠肛门癌的SIR分别为4.06、0.43和0.10，分别低于2004年至2013年的7.42、1.96和0.84，差异均有统计学意义(n χ2＝5.39、19.52、10.86，均n P<0.05)。n 结论:目前艾滋病合并恶性肿瘤的发病率与普通人群无明显差异，但肿瘤类型存在差异。本地区最常见的恶性肿瘤是NHL和宫颈癌，应注意在该类肿瘤患者中筛查HIV，有助于开展综合治疗以提高疗效。“,”Objective:To investigate the epidemic trend and risk change of acquired immunodeficiency syndrome (AIDS) complicated with malignant tumors after combination antiretroviral therapy (cART).Methods:The types of malignant tumors in patients with AIDS at different stages of cART were analyzed among anti-human immunodeficiency virus (HIV)-positive population in Hubei Province screened in National AIDS/HIV prevention and control information system from 1st January, 2004 to 31st December, 2018. The standardized incidence ratios(SIR) of malignant tumors in AIDS patients was analyzed based on the incidence of malignant tumors in the general population in Hubei Province or China in 2013. The changes in risks for development of malignant tumors in AIDS patients at different cART stages from 2004 to 2013 and 2014 to 2018 were compared.Chi-square test was used for statistical analysis.Results:Three hundred and twenty-three out of 22 994 AIDS patients were diagnosed with malignant tumors. Non-Hodgkin lymphoma(NHL) and cervical cancer were most common types in acquired immunodeficiency syndrome-defining cancers (ADC), while liver cancers and lung cancers were the most common types in non-acquired immunodeficiency syndrome-defining cancers (NADC). The overall risk of malignancy in AIDS patients was similar to that in the general population (SIR=1.06, n χ2=0.62, n P=0.426). However, the risks of Kaposi sarcoma, NHL, Hodgkin lymphoma, cervical cancer, and head and face cancers (excepting nasopharyngeal cancer) in AIDS patients were significantly higher than those in the general population (SIR=834.09, 9.65, 13.33, 5.22 and 2.94, respectively, n χ2=11 747.27, 625.54, 56.65, 184.21 and 13.66, respectively, all n P<0.01). The risks of lung cancer, colorectal anal cancer, stomach cancer and breast cancer in AIDS patients were significantly lower than those in the general population (SIR=0.33, 0.36, 0.43 and 0.45, respectively,n χ2=33.43, 12.84, 9.01 and 7.21, respectively, all n P<0.05). The SIR of cervical cancer, liver cancer and colorectal anal cancer from 2014 to 2018 were 4.06, 0.43 and 0.10, respectively, which were significantly lower than those from 2004 to 2013 (7.42, 1.96 and 0.84, respectively). The differences were all statistically significant (n χ2=5.39, 19.52 and 10.86, respectively, all n P<0.05).n Conclusions:At present, there are no significant differences of the incidences of malignant tumors between AIDS patients and general population, but the tumor types are different. The most common malignant tumors in this region are NHL and cervical cancer, which should be noted that HIV screening among patients with such tumors is conducive to comprehensive treatment to improve the efficacy.