In this study, we attempt to evaluate specific risk factors including age and stage of lung cancer diagnosis, histopathology of lung cancer type, gender, race and degree of immunosuppression (CD4 count) that could be utilised to predict the survival outcome of HIV-infected patients with lung cancer. In this study, we essentially compare the intervention and surivival outcomes of HIV-positive and age and stage-matched HIV negative controls with lung cancer in the HAART era.
The clinical characteristics of the 8 patients with HIV-related lung cancer, diagnosed between 2000 and 2007, were obtained from the lung cancer registry databases of an inner city medical center. The HIV-negative control group was also retrieved from the same databases. For each HIV-positive lung cancer patient, 1 HIV-negative controls who had the same stage and histopathological type of lung cancer and were within 1 year of age of the case of the patient.We specifically looked at age, race, gender, history of smoking and intravenous drug use, date of diagnosis of HIV and Lung Cancer, CD4 count at diagnosis, treatment and response to treatment and survival.
The median overall survival for patients with HIV-related and non-HIV lung cancer was 5 months and 13 months respectively. The median survival for Stage3/4 cancer for HIV and non-HIV lung cancer was 3.5 months and 2 months respectively.
There is a worse survival with HIV-related lung cancer in patients from the inner city. It is uncertain whether this is due to more aggressive lung cancer or diagnostic delays and suboptimal treatment compared to non-HIV cancer patients.
In the HAART era, it is important to encourage compliance with HAART and cancer chemotherapy to improve survival. Improvement in cd4 count may be a good prognostic factor especially in the advanced lung cancer of any histopathologic type.
Neenos Abd Al-Noor, No Financial Disclosure Information; No Product/Research Disclosure Information