Lung cancer in persons with HIV

Abstract

Purpose of Review Lung cancer is emerging as a leading cause of death in HIV infected persons. This review will discuss the latest scientific evidence regarding the mechanisms driving lung cancer risk in HIV infection, the clinical presentation of lung cancer in HIV infected persons, and recent data regarding the outcomes, treatment and prevention of lung cancer in this group. Recent Findings Increased risk of lung cancer in HIV infected persons is primarily due to higher smoking rates, but emerging evidence also implicates immunosuppression and inflammatory processes. Lung cancer outcomes may be worse in HIV infected persons in the anti-retroviral era but this may stem, in part, from treatment disparities. Early detection of lung cancer using chest computed tomography (CT) is being increasingly adopted for smokers in the general population and recent studies suggest it may be safe and efficacious in HIV infected smokers. Summary Lung cancer is an important complication associated with chronic HIV infection. It is associated with unique HIV-related causal mechanisms, and may be associated with worse outcomes in some HIV infected persons. Smoking cessation and early cancer detection with chest CT are likely to benefit HIV infected smokers.

Management of immune checkpoint inhibitor‐related adverse events: A review of case reports

“…It was reported that highly active antiretroviral therapy improved the survival of patients with HIV, which increased the incidence of malignancies . Li et al .…”

Oncogenic spiral by infectious pathogens: Cooperation of multiple factors in cancer development

“…The risk of lung cancer is higher in HIV‐infected subjects than in the general population, and the higher smoking rate in the HIV‐infected population is one of the factors explaining this trend . In addition, recent studies show that immunosuppression by HIV and chronic inflammation are involved in oncogenesis . It is known that HIV infection is a risk factor for cancers of the conjunctiva and the lip .…”

Clinical and scientific challenges in HIV-associated malignancies

“…Key among these is tobacco cessation, as people with HIV continue to report higher rates of smoking than the general population. Sigel et al describe the importance of this in the observed elevated risk of lung cancer among people with HIV [8]. They further outline recent data supporting a possible role for CT screening for lung cancer in selected, high risk patients with HIV [9].…”

“…Work continues to establish specific approaches for people with HIV with common solid tumors including lung, anogenital, and hepatocellular malignancies [6–8]. As new therapeutic modalities are rapidly emerging for the general population in these and many other solid tumours, ongoing developmental therapeutic studies hold the promise of establishing clear safety and tolerability data to guide clinical care in people with HIV.…”