title: Impact of Human Immunodeficiency Virus in the Pathogenesis and Outcome of Patients with Glioblastoma Multiforme.
abstract: BACKGROUND
  Improvement in antiviral therapies have been accompanied by an increased frequency of non-Acquired Immune Deficiency Syndrome (AIDS) defining malignancies, such as glioblastoma multiforme. Here, we investigated all reported cases of human immunodeficiency virus (HIV)-positive patients with glioblastoma and evaluated their clinical outcomes. A comprehensive review of the molecular pathogenetic mechanisms underlying glioblastoma development in the setting of HIV/AIDS is provided.
  
  
  METHODS
  We performed a PubMed search using keywords "HIV glioma" AND "glioblastoma," and "AIDS glioma" AND "glioblastoma." Case reports and series describing HIV-positive patients with glioblastoma (histologically-proven World Health Organization grade IV astrocytoma) and reporting on HAART treatment status, clinical follow-up, and overall survival (OS), were included for the purposes of quantitative synthesis. Patients without clinical follow-up data or OS were excluded. Remaining articles were assessed for data extraction eligibility.
  
  
  RESULTS
  A total of 17 patients met our inclusion criteria. Of these patients, 14 (82.4%) were male and 3 (17.6%) were female, with a mean age of 39.5±9.2 years (range 19-60 years). Average CD4 count at diagnosis of glioblastoma was 358.9±193.4 cells/mm3. Tumor progression rather than AIDS-associated complications dictated patient survival. There was a trend towards increased median survival with HAART treatment (12.0 vs 7.5 months,p=0.10).
  
  
  CONCLUSIONS
  Our data suggests that HAART is associated with improved survival in patients with HIV-associated glioblastoma, although the precise mechanisms underlying this improvement remain unclear.
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: Winward
authors.initials: W
authors.lastname: Choy
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: Carlito
authors.initials: C
authors.lastname: Lagman
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: Seung J
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: Timothy T
authors.initials: TT
authors.lastname: Bui
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Safaee
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA.; Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: Isaac
authors.initials: I
authors.lastname: Yang
keywords: Acquired Immune Deficiency Syndrome; Antiretroviral therapy, highly active; Glioblastoma; HIV