Cancer in patients with HIV infection: A new epidemiology

Abstract

11108 Background: Cancer is the leading cause of death in patients who have HIV infection. HAART has had a dramatic impact on life expectancy and the incidence of AIDS defining and Non AIDS defining cancer appears to be changing. Methods: We undertook a three-year retrospective review of Brookdale’s inpatients over 18 years, diagnosed with cancer, who were HIV positive. We correlated the CD4 count of the patients to the type of cancer. Results: Fifty charts were reviewed. Twenty-four patients were female, 26, male. Median age was 47 years (26 - 70). Twenty four (48%) patients had AIDS-defining and 26 (52%) had non-AIDS-defining cancers. Twelve (24%) had NHL. Ten had lung cancer, nine (18%) of them are non-small cell. Seven (14%) had KS, six, (12%) cervical carcinoma. Three (6%) had Hodgkin’s lymphoma. Two had anal cancer, two, breast cancer, three, nasopharyngeal, one, skin cancer, one, gastric cancer, one, hepatocellular and one, prostate cancer.CD4 counts were less than 200/ml in all patients with KS (mean 30/ml) and cervical cancer (mean 75/ml). All Hodgkin’s lymphoma patients had CD4’s over 200/ml (mean, 554). In NHL, ten of twelve (83%) had CD4’s less than 200/ml (mean, 137/ml). Of non-small cell lung cancer patients, six (67%) had CD4’s less than 200/ml (mean, 139/ml). The mean CD4 in patients with non-AIDS-defining malignancies was 263/ml (SD 255). Conclusions: In the era of HAART, HIV patients are at risk for non-HIV associated cancers, as that of AIDS-defining cancers and non-small cell cancers were the most common of non-HIV-associated cancers. Even with non-AIDS-defining malignancies, many patients present with low CD4’s. In this small study we cannot determine whether immunosuppression from HIV increases the risk of all cancers and will need larger multi institutional studies. Cancer Number of Cancers Number of patients with CD4 <200 Mean CD4 Count NHL 12 (24%) 10 (83%) 137 (122) Non small cell lung cancer 9 (18%) 6 (67%) 139 (SD 104) Kaposi’s sarcoma 7 (14%) 7 (100%) 30 (28) Cervical Cancer 6 (12%) 6 (100%) 75(29) Hodgkin’s Lymphoma 3 (6%) 0 554 (359) No significant financial relationships to disclose.