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Author Notes:

Correspondence: Suresh S. Ramalingam, MD, 1365 Clifton Road NE, Rm C-3090 Atlanta, GA 30322. Email: suresh.ramalingam@emory.edu

Subjects:

Research Funding:

Supported by NIH P01 CA116676. TKO, DMS, WJC, FRK and SSR are Distinguished Cancer Scholars of the Georgia Cancer Coalition.

Keywords:

  • lung cancer
  • HIV
  • survival
  • anti-retroviral therapy
  • HAART

HIV-Associated Lung Cancer in the Era of Highly Active Antiretroviral Therapy (HAART)

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Journal Title:

Cancer

Volume:

Volume 118, Number 1

Publisher:

, Pages 164-172

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Background Lung cancer is the leading cause of death among non-acquired immunodeficiency syndrome (AIDS) defining malignancies. Since highly active anti-retroviral therapy (HAART) has improved survival for human immunodeficiency virus (HIV) patients, we evaluated lung cancer outcomes in the HAART era. Methods HIV-positive patients diagnosed with lung cancer in our institution during the HAART era (1995-2008) were analyzed. Patient charts were reviewed for clinical and laboratory data. CD4 count at diagnosis was treated as a continuous variable and subcategorized into distinct variables with 3 cut-off points (50, 200, & 500 μl). Pearson’s correlation coefficients were estimated for each covariate studied. Survival was determined by the Kaplan-Meier method. Results Out of 80 patients, 73 had non-small cell lung cancer. Baseline characteristics were: median age-52 yrs; male-80%; African American-84%; injection drug use-25%; smokers-100%; and prior exposure to antiretroviral agents-55%. Mean CD4 count and viral load were 304 μL and 82,420 copies/ml, respectively at cancer diagnosis. The latency between diagnosis of HIV and lung cancer was significantly shorter in women (4.1 yrs vs. 7.7 yrs, P=0.02) and 71% of the patients received anti-cancer therapy. The 1- and 3-year survival rates were 31% and 4% overall. Grade 3/4 toxicities occurred in 60% with chemo-radiation vs. 36% with chemotherapy. Cancer-related survival was better for patients with CD4 count >200 (P=0.0298) and >500 (P=0.0076). Conclusions The latency from diagnosis of HIV to lung cancer was significantly shorter for women. Although outcomes for lung cancer patients with HIV remain poor, high CD4 count is associated with an improved lung cancer-related survival.

Copyright information:

© 2011 American Cancer Society

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