Lung Cancer in HIV Infection

Abstract

Lung cancer is the most prevalent non-AIDS-defining malignancy in the HAART era. Smoking plays a significant role in the development of HIV-associated lung cancer, but the cancer risk is 2–4 times greater in HIV-infected persons than in the general population, even after adjusting for smoking intensity and duration. Lung cancer is typically diagnosed a decade or more earlier among HIV-infected persons (mean age, 46 years) compared to those without HIV infection. Adenocarcinoma is the commonest histological subtype, and the majority of patients are diagnosed with locally advanced or metastatic carcinoma. Since pulmonary infections are common among HIV-infected individuals, clinicians may not suspect lung cancer in this younger patient population. Surgery with curative intent remains the treatment of choice for early stage disease. Although there is increasing experience in using radiation and chemotherapy for HIV-infected patients who do not have surgical options, there is a need for prospective studies for this population frequently excluded from participating in cancer trials. Evidence-based treatments for smoking-cessation with demonstrated efficacy in the general population must be routinely incorporated into the care of HIV-positive smokers.

Epidemiology, risk factors, symptomatology, TNM classification of Non Small Cell Lung Cancer. An overview while waiting the 8th TNM classification

“…The most common subtype of NSCLC in this patient group is adenocarcinoma. It seems that the risk is higher in patients who are or used to be smokers (23). However this statement is under debate (22).…”

Non-AIDS definings malignancies among human immunodeficiency virus-positive subjects: Epidemiology and outcome after two decades of HAART era

“…Two metaanalysis estimated that the risk of lung cancer in HIVinfected people was more than two fold higher than in the general population [25,26] , and the risk is relevant for all main lung cancer subtypes (squamous cell carcinoma, adenocarcinoma and small cell carcinoma). Male sex is more affected, and the mean age when diagnosis of lung cancer occurs is about 15 years lower than in HIVnegative people [27] . Cigarette smoking is the most important risk factor for developing lung cancer and the prevalence of tobacco use among HIVpositive people is higher than in the general population, ranging from 40% to 70% compared to 20% observed among HIVnegative people [2830] .…”

Neues bei HIV und Neuro-Aids

“…HIV-positive Patienten haben ein höheres Risiko, bestimmte Krebsformen zu entwickeln als HIV-negative Menschen [70]. Hierbei unterscheiden sich AIDS-definierende Krebsformen wie das Kaposi-Sarkom oder das Non-Hodgkin-Lymphom von nicht AIDS-definierenden Formen wie Lungenkarzinomen, Analkarzinomen, Leberkarzinomen und nicht-Melanom-bedingten Hauttumoren [71]. In den westlichen Industrieländern mit breitem Zugang zu medizinischer Versorgung und antiretroviraler Therapie sind selbstverständlich die nicht AIDS-definierenden Tumoren bedeutsamer.…”