Patients With HIV Face Increased Risk of Mortality From Lung Cancer

The increased risk of cancer in patients with HIV has been well defined, and some studies have suggested that patients with HIV have not only a higher risk of lung cancer, but also an increased risk of mortality from their cancer than patients without HIV.

While it is clear that there is a higher incidence of smoking among people living with HIV, it has also been suggested that, because HIV is associated with poor immune regulatory function, infection can lead to metastasis of tumor cells. It has also been proposed that the respiratory system is particularly susceptible to immunosuppression related to HIV. While the mechanisms that explain the association between HIV and mortality from lung cancer remain elusive, a recent study, published in Medicine, sought to assess the impact of HIV status on mortality form lung cancer.

Using the PubMed and Embase databases, researchers from China conducted a review of studies that assessed the association between HIV infection and mortality among patients with lung cancer, and found 12 studies that met quality standards for inclusion.

In the meta-analysis of the studies, the pooled relative risk (RR) of mortality among patients with lung cancer who had HIV was 1.48 (95% CI, 1.22-1.78; P =.001), and by histological types, among the 3 studies that involved patients with non—small cell lung cancer (NSCLC), HIV was significantly associated with an elevated risk of mortality (RR, 1.69; 95% CI, 1.48-1.94; P <.001).

In a sensitivity analysis, after excluding 2 studies with low-quality evidence, HIV was still significantly associated with an elevated risk of mortality among patients with lung cancer. (RR, 1.51; 95% CI, 1.25-1.82; P <.001).

According to the authors, this paper is the first meta-analysis of studies on the association of HIV infection and mortality risk from lung cancer, and while the biological mechanisms that underlie the association are unclear, the authors suggest that HIV status can be an important prognostic factor in patients with lung cancer.

Reference

Wang YH, Shen XD, Human immunodeficiency virus infection and mortality risk among lung cancer patients: a systematic review and meta-analysis. Medicine. 2018;97(15):30361. doi: 10.1097/MD.0000000000010361.