437. Correlating age-at-diagnosis of lung cancer in the HIV/AIDS population
Session: Poster Abstract Session: HIV Challenges and Complications
Friday, October 21, 2011
Room: Poster Hall B1
Handouts
  • 11-10-6 IDSA Poster.pdf (140.5 kB)
  • Background: Lung cancer is increasing in the HIV/AIDS population. A 2-to-5-fold increase in lung cancer risk is reported for persons with HIV/AIDS (PWA) compared to the general population [Engles, AIDS 2006].  This observation cannot be fully explained by patterns of tobacco use [Kirk, HIV/AIDS 2007].  Chronic pulmonary inflammation, infectious and non-infectious, may potentiate the effects of smoking, increasing the risk of lung cancer.  Some reports suggest lung cancer risk is unrelated to immunosuppression [Chaturvedi, AIDS 2007] while others paradoxically find a definitive correlation [Guiguet, Lancet Oncol 2009].  Studies examining age-at-onset of lung cancer in PWA have shown a younger age-at-onset of lung cancer diagnosis in PWA compared to the general population; namely 50 versus 54-years-old, respectively [Shiels, Ann Intern Med 2010].  Data is not available comparing age-at-diagnosis and lag time between HIV and lung cancer. Methods: We queried the Center for AIDS Research database at the University of Pennsylvania with over 3000 patients with HIV, specifically searching for those with lung cancer. The query included age, sex, race, smoking status, dates of HIV and lung cancer diagnoses, and CD4+ cell counts throughout the study period. Results: From 1983 to 2011, lung cancer was identified among 30 PWA. The average ages of HIV and lung cancer diagnoses were 40 and 52, respectively. Patients developed lung cancer within 11 years (average) of their initial HIV diagnosis [Figure 1]. The lag time between HIV and lung cancer diagnoses, however, were substantially lower in recent years, decreasing from 11 to <3 years after 1997 [Figure 2].  Conclusion: Lung cancer occurs at a younger age in the HIV population than in the general population for reasons that remain unclear.  After 1997, the average interval between HIV and cancer diagnoses shifted dramatically from 11 years to <3 years. It is noteworthy that the HIV treatment paradigm changed in the 1990s with the advent of HAART, particularly protease inhibitors. Our preliminary data suggest that despite restoring immune system functionality with HAART the predisposition to lung cancer may be enhanced.

    Figure 1: Age-at-Diagnosis of HIV and Lung Cancer

    Figure 2: Lag Time from HIV-to-Lung Cancer Diagnosis


    Subject Category: H. HIV/AIDS and other retroviruses

    Justine Cohen, DO, Internal Medicine , Pennsylvania Hospital, University of Pennsylvania , Philadelphia, PA, John Stern, MD, Infectious Diseases, Pennsylvania Hospital, University of Pennsylvania , Philadelphia, PA and David Henry, MD, Hematology and Oncology, Pennsylvania Hospital, University of Pennsylvania Hospital , Philadelphia, PA

    Disclosures:

    J. Cohen, None

    J. Stern, None

    D. Henry, None

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.