Clinical and computed tomography findings in Chinese lung cancer patients with HIV infection: A multi‐center study

Abstract

BackgroundThe study was conducted to investigate clinical and computed tomography (CT) features in Chinese lung cancer patients with human immunodeficiency virus (HIV).MethodsForty consecutive lung cancer patients with HIV were included. Clinical data were collected, and CT features were reviewed and measured. The factors associated with stages of cancer and the CT features with opportunistic pulmonary infections (OPIs) were also analyzed.ResultsThirty‐four of the patients were men (85%), and the mean age was 57.5 years. The mean CD4 count was 288 cells/μL, and 23 patients received highly active antiretroviral therapy. OPIs were common (50%). The major histological type (85%) was non‐small cell lung cancer (NSCLC), and 15 NSCLC patients (44%) were in stages IIIb and IV. NSCLC patients with an OPI were more common in the advanced stages compared with those without an OPI (P = 0.04). There were no significant differences in advanced and non‐advanced stages in terms of CD4 level, highly active antiretroviral therapy, and smoking (P = 0.31, P = 1.00; P = 0.49, respectively). The average size of tumors was 4.5 cm. Irregularly shaped or larger sized tumors were associated with OPIs (P = 0.03, P = 0.04, respectively).ConclusionsThe persistence of locally irregular and large lesions in middle‐aged men with HIV and a history of OPIs should be an alert for lung cancer, and clinical management is needed.

The interrelationship of smoking, CD4+ cell count, viral load and cancer in persons living with HIV

“…Non-HIV specific risk factors for cancer are well described and include obesity as well as coinfections, that is oncogenic viruses such as human papilloma virus (HPV) and viral hepatitis [29], while chronic inflammation may also play a role [30,31]. Taken together, these findings could suggest that the association between smoking and cancer varies based on HIVrelated immune impairment and inflammation, which potentially increases the carcinogenic effects of smoking on PLWH [22,[32][33][34][35]. To date, there is no evidence to support this hypothesis.…”

HIV‐1, HAART and cancer: A complex relationship

“…The absence of HAART was not proven to be an independent risk factor for NADCs . HAART exposure did not play any role in lung cancer staging . No association was shown between HAART use and the risk of lung cancer .…”

“…19 HAART exposure did not play any role in lung cancer staging. 106 No association was shown between HAART use and the risk of lung cancer. 107,108 The opposite trend is observed in prostate cancer, where the cumulative antiretroviral exposure decreases cancer risk, though no difference was observed between people with or without antiretroviral therapy.…”

Recent advances in cancer outcomes in HIV-positive smokers

“…A similar study conducted on Chinese cohorts by Cheng et al . suggested that the majority (85%) of the HIV patients with lung cancer had non-small cell carcinoma and that nearly half of the study groups were at stage IIIb and IV of lung cancer 36 .…”