Lung cancer in patients with HIV Infection and review of the literature.
BACKGROUND
The improved survival of patients since the use of highly active antiretroviral treatments has lead to the reporting of non-AIDS defining tumors, such as lung cancer.


METHODS
Analysis of the records of 22 HIV-infected patients with lung cancer (LC) diagnosed in three hospitals located in the Paris area (France).


RESULTS
Twenty-one patients were smokers. The patients (86% male, 14% female) had a median age of 45 yr (range, 33-64 yr). Risk factors for HIV infection were intravenous drug use in 5 patients, homosexual transmission in 10 patients, and heterosexual transmission in 7 patients. At diagnosis of LC, seven patients had previously developed a CDC-defined AIDS manifestation, the median CD4 cell count was 364/mm3 (range 20-854/mm3) and median HIV1 RNA viral load was 3000 copies/mL. The most frequent histological subtype was squamous cell carcinoma (11 cases). A stage III-IV disease was observed in 75% of the patients. Only one patient had a small-cell lung carcinoma. Twenty-one patients received combined specific therapy, of which six patients underwent surgery for the LC. The median overall survival was 7 mo. No opportunistic infections occurred during LC therapy.


CONCLUSIONS
LC occurs at a young age in HIV-infected smokers. LC is not associated with severe immunodeficiency. The prognosis is poor because of their initial extensive disease and a poor response to therapy. However, surgery appears to improve outcome in much the same way as in the general population.
Spano
Jean-Philippe
JP
Pitie-Salpetriere Hospital, Department of Medical Oncology, bld de I'Hopital, 75013 Paris, France. jean-phillipe.spano@psl.ap-hop.paris.fr
Massiani
Marie-Ange
MA
Bentata
Michele
M
Rixe
Olivier
O
Friard
Sylvie
S
Bossi
Philippe
P
Rouges
François
F
Katlama
Christine
C
Breau
Jean-Luc
JL
Morere
Jean-Francois
JF
Khayat
David
D
Couderc
Louis-Jean
LJ
D000328:Adult; D017668:Age of Onset; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008175:Lung Neoplasms / Q000209:etiology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D019966:Substance-Related Disorders