Lung Cancer |

Lung Cancer in HIV Positive Patients, in the Era of Highly Active Antiretroviral Therapy FREE TO VIEW

Narjust Duma, MD; Jaimie Mittal, MD; Sobia Nizami, MD; Mohleen Kang, MD; David Cennimo, MD
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Rutgers-New Jersey Medical School, Newark, NJ

Chest. 2015;148(4_MeetingAbstracts):551A. doi:10.1378/chest.2270796
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SESSION TITLE: Lung Cancer Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: With the introduction of antiretroviral therapies (HAART) the causes of mortality in HIV patients (pts) have changed considerably. The incidence of lung cancer has risen dramatically in these pts, with lung cancer being a major contributor to mortality in HIV-positive pts. Our objective was to determine the characteristics of non-small cell lung cancer (NSCLC) in HIV-positive pts and compare them with HIV-negative NSCLC pts.

METHODS: We reviewed the charts of 1440 HIV-positive pts that followed at our institution’s infectious disease clinic from 2000 to 2010. Demographics, CD4 counts and NSCLC characteristics were studied.

RESULTS: A total of 19 (1.34%) pts with NSCLC were identified; there were more females than males (68%vs 32%). Regarding HIV infection: median (M) age of HIV diagnosis was 43 years (22-66), the most common modes of infection were heterosexual contact (53%) and IV drug use (31%). M CD4 at diagnosis was 71 (12-800). 89.5% of pts had been in HAART therapy, but only 47% were compliant with the regimen. About co-infections: 47% had hepatitis C and 21% hepatitis B. 95% were current or former smokers. In regards to NSCLC, M age at diagnosis was 50 years (43-69), M CD4 count at cancer diagnosis was 252 (13-818), 79% of the pts were stage IV at diagnosis, 84% of the pts were symptomatic at diagnosis with almost half of these pts (47%) having a prior lung infection. Adenocarcinoma was the most prevalent histologic subtype followed by squamous cell. Following cancer diagnosis, only 32% of the pts received a combination of chemotherapy and HAART therapy. Compared with HIV-positive pts, the HIV-negative pts were older at diagnosis (M age 70 years), contained fewer smokers (55%), and had a greater frequency of squamous cell carcinomas (38% vs. 16%), with only 61%of the of pts presenting with stage IV NSCLC.

CONCLUSIONS: We observed a higher incidence of NSCLC in HIV-positive young females. Most of the pts presented with advanced disease and almost half of these pts had a prior lung infection. Our HIV-positive pts were 20 years younger at the time of diagnosis compared with the national median age of NSCLC diagnosis (70 years).

CLINICAL IMPLICATIONS: NSCLC HIV-positive pts tend to have a worse prognosis than the general population, management can be difficult as many pts present with advanced disease and co-infections. The risk of NSCLC based on gender differences, especially among HIV-positive females requires further investigation at this could impact cancer screening in the HIV-positive population.

DISCLOSURE: The following authors have nothing to disclose: Narjust Duma, Jaimie Mittal, Sobia Nizami, Mohleen Kang, David Cennimo

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