Lung cancer in association with human immunodeficiency virus infection

Abstract

The association of lung cancer and infection by the human immunodeficiency virus (HIV) is uncommon. This report and critical review of the medical literature defines a clinical profile of 22 patients affected with this uncommon association. This clinical profile includes young age (median, 38 years), intravenous drug abuse (14 of 22 patients), preponderance of adenocarcinoma over other cell subtypes (11 of 22 patients), and advanced clinical stage at presentation (10 of 15 patients with staging data had Stage III or IV disease). This study also examines a possible increased risk for lung cancer in patients infected by HIV. Continued surveillance and reporting of lung tumors (other than lymphomas and Kaposi sarcomas) in patients infected by HIV should help to define the frequency of the association and the validity of the clinical profile. Cancer 1992; 70:432–436.

Endobronchial Lesions in HIV-infected Individuals

“…In the series of Fraire and Awe, 63 where the location of the tumor was described, three of the ten patients had an endobronchial lesion. Several of these patients had adenocarcinomas which tend to be peripheral.…”

“…However, the estimation has been criticized because no adjustment was made for age, sex, race, or smoking status. 63 Although lung cancer may not be more frequent in HIV -infected individuals, its clinical course appears to be different . Fraire and Awe 63 reviewed 21 cases of lung carcinoma associated with HIV infection reported between 1983 and 1991.…”

Lung cancer in HIV infected patients: facts, questions and challenges

“…16 38 Some studies from the pre-HAART era suggest, however, that lung cancer appears relatively early in the course of HIV infection. 9 10 42 HIV+ patients with lung cancer do not seem to be particularly immunosuppressed, having a median CD4+ count at lung cancer diagnosis of 250/ml; 50% had counts .200/ml and ,60% had yet to develop AIDS. 5 43 44 In addition, the degree of immunosuppression was found to be less in the HAART period than in the pre-HAART period in two recent epidemiological studies.…”

Lung cancer, a new challenge in the HIV-infected population

“…In contrast, no link emerged between LC onset and the degree of immune deficiency [7,8]. In the early 1990s, certain epidemiological studies [9,10] and clinical series [11,12] pointed to an increase in the risk of LC among HIV-infected patients relative to the general population, and also confirmed the poorer prognosis of LC in this setting. In 1996, mortality due to AIDS started to fall sharply in industrialized countries after the introduction of highly active antiretroviral treatments (HAART) [13].…”