A comparison of lung cancer in HIV-positive and HIV-negative populations

Abstract

Background: Lung cancer is the most common cancer worldwide and is the greatest contributor to malignancy associated deaths. Human Immunodeficiency Virus (HIV) is an epidemic in many developing countries and South Africa carries the largest burden of disease in the world. With the introduction of antiretroviral therapy (ART), Acquired Immune Deficiency Syndrome (AIDS) defining malignancies (ADM’s) are on the decline and non AIDS defining malignancies (NADM’s) are becoming more common with lung cancer being the commonest amongst these. Aim: To describe a cohort of HIV-positive lung cancer patients and a cohort of HIV-negative lung cancer patients and compare the similarities and differences between the two groups. Methods: A retrospective study of 188 patients with histologically confirmed bronchogenic carcinoma was conducted. Smoking history, cancer sub-type, cancer stage, HIV parameters, and demographic data were collected. Results: There were 31 (16.94%) HIV-positive patients. They presented at a younger age (53.94 years) than the HIV-negative group (61.64 years) (p = 0.0001). Adenocarcinoma was the commonest sub-type in the HIV-negative cohort while squamous cell carcinoma was slightly more common in the HIV-positive cohort. Both groups predominantly presented with locally advanced or metastatic disease. Conclusion: HIV-positive patients present at a younger age than HIV-negative patients and both groups show a male predominant pattern. We were unable to assess whether smoking was more common in either group or whether HIV-positive patients present at a more advanced stage than HIV-negative patients due to a paucity of data.