Human immunodeficiency virus-related renal cell carcinoma: a retrospective study of 19 cases

Abstract

Purpose We aimed to investigate basic information, clinical findings, treatments for tumor, pathology, and outcomes of HIV-positive patients diagnosed with renal cell carcinoma (RCC). Patients and methods We collected 19 patients from 2012 to 2020 who are diagnosed with RCC with HIV-positive. A retrospective analysis was performed on their hospitalization course and tumor-related parameters, including basic information, clinical findings, HIV-associated data, pathology, treatments for tumor, and outcomes. Results In our study, patients were diagnosed with RCC at the median age of 51. Males took a great part (17 males, 89%) in all patients, while only 2 females were diagnosed. The median CD4+ T lymphocyte cell count was 462 cells/μl when diagnosed with RCC (range from 111 cells/μl to 1536 cells/μl). Eleven patients diagnosed with RCC and HIV infection at the same time, who may have high viral load and low CD4+ T lymphocyte cell count. Eight patients accepted a median HAART for 30 months (range from 11 months to 108 months) prior to diagnosis of RCC. All the patients performed operations successfully, and 4 of them performed partial nephrecotomy. Only 1 patient was identified with chromophobe cell carcinoma, 1 with partially clear cell and partially papillary carcinoma, and 17 with clear cell carcinoma. Two of the patients with Fuhrman grades 2–3 accepted cytokine therapy with IL-2 and IFN-α. Two patients died of lung metastasis 1 year and 6 months after surgery respectively, even though 1 patient accepted full dose targeted therapy (sorafenib) for 3 months, and one refused adjuvant therapy. The remaining 17 patients are still alive at a median follow-up of 34 months; however, 1 patient lives with lung and brain metastases at the last follow-up of 3 years after surgery. Conclusions RCC patients with HIV-positive were similar to the general population in terms of clinical characters, treatment measures, and pathology. RCC patients with HIV-positive seemed like to obey the same clinical practice guideline as in the general population. The outcomes of HIV-positive patients with partial nephrectomy are not inferior to patients with radical nephrectomy. Furthermore, experience in targeted therapy and immunal therapy (PD-1/PD-L1 inhibitors) needs to be learned.

Renal Cell Carcinoma Associated With HIV/AIDS: A Review of the Epidemiology, Risk Factors, Diagnosis, and Treatment

“…Zhang and Zhu et al from Beijing Youan Hospital reported 19 HIV-infected patients diagnosed with RCC. They concluded that there was no evidence to support a relationship between immune deficiency and tumor progression, even though some patients did not undergo regular ART (49). Overall, recent studies have tended to consider that there is insufficient evidence to prove an association between HIV-induced immunodeficiency and RCC.…”

“…With the use of more imaging techniques, early-stage RCC can be detected incidentally, improving the cure rate and survival time of patients. Some case reports showed that there were no marked differences in pathology between RCC with and without HIV (45,48,49). In 2008, Gaughan et al reported nine RCC patients with HIV, six of whom had ccRCC (45).…”

Comprehensive RNA-seq reveals molecular changes in kidney malignancy among people living with HIV

“…recently found that the clinical characteristics, treatment measures, and pathology of 19 HIV-positive renal cell carcinoma (RCC) patients were similar to those of the general population. 12 Although similar to RCC, HIV-associated kidney cancer has a poor prognosis in an advanced stage and is difficult to detect early due to the lack of molecular biomarkers 13 and the incidence of RCC in the HIV-positive population is greater than that in the non-HIV population. 14 , 15 In a large meta-analysis of seven population-based HIV cancer studies involving more than 400,000 HIV-positive patients, Grulich et al.…”

Comparative analysis of clinical treatment of HIV positive and HIV negative bladder cancer patients

“…As highe ciency combined anti-retrovirus therapy (HAART) is widely used, gradually extend the life of people living with HIV, the incidence of HIV merger other diseases is higher, because HIV CD4 + T lymphocyte number decreasing, and even complete loss reduction in immune function of human cells, lead to all sorts of opportunistic infections and tumors, and It has been reported that HIV infection can be a risk factor for Kaposi's sarcoma and non-Hodgkin's lymphoma 3,4. At the same time, HIV-associated urological tumors have attracted the attention of urology experts. Bladder cancer is the most common urological malignancy and the tenth most common malignancy in the world 5 . In current studies at home and abroad, the correlation between bladder cancer and HIV infection remains unclear.…”