title: Prognosis in HIV-infected patients with non-small cell lung cancer.
abstract: BACKGROUND
  We conducted a population-based study to evaluate whether non-small cell lung cancer (NSCLC) prognosis was worse in HIV-infected compared with HIV-uninfected patients.
  
  
  METHODS
  Using the Surveillance, Epidemiology and End Results (SEER) registry linked to Medicare claims, we identified 267 HIV-infected patients and 1428 similar controls with no evidence of HIV diagnosed with NSCLC between 1996 and 2007. We used conditional probability function (CPF) analyses to compare survival by HIV status accounting for an increased risk of non-lung cancer death (competing risks) in HIV-infected patients. We used multivariable CPF regression to evaluate lung cancer prognosis by HIV status adjusted for confounders.
  
  
  RESULTS
  Stage at presentation and use of stage-appropriate lung cancer treatment did not differ by HIV status. Median survival was 6 months (95% confidence interval (CI): 5-8 months) among HIV-infected NSCLC patients compared with 20 months (95% CI: 17-23 months) in patients without evidence of HIV. Multivariable CPF regression showed that HIV was associated with a greater risk of lung cancer-specific death after controlling for confounders and competing risks.
  
  
  CONCLUSIONS
  NSCLC patients with HIV have a poorer prognosis than patients without evidence of HIV. NSCLC may exhibit more aggressive behaviour in the setting of HIV.
authors.affiliation: Division of General Internal Medicine, Mount Sinai School of Medicine, New York, NY, USA.
authors.forename: K
authors.initials: K
authors.lastname: Sigel
authors.forename: K
authors.initials: K
authors.lastname: Crothers
authors.forename: R
authors.initials: R
authors.lastname: Dubrow
authors.forename: K
authors.initials: K
authors.lastname: Krauskopf
authors.forename: J
authors.initials: J
authors.lastname: Jao
authors.forename: C
authors.initials: C
authors.lastname: Sigel
authors.forename: A
authors.initials: A
authors.lastname: Moskowitz
authors.forename: J
authors.initials: J
authors.lastname: Wisnivesky
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications* / Q000175:diagnosis / Q000401:mortality* / Q000473:pathology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000401:mortality*; D006801:Humans; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018426:SEER Program; D015996:Survival Rate; D014481:United States
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