Lung cancer incidence and survival among HIV-infected and uninfected women and men

Nancy A. Hessol, Otoniel Martínez-Maza, Alexandra M. Levine, Alison Morris, Joseph B. Margolick, Mardge H. Cohen, Lisa P. Jacobson, Eric C. Seaberg

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To determine the lung cancer incidence and survival time among HIVinfected and uninfected women and men. Design: Two longitudinal studies of HIV infection in the United States. Methods: Data from 2549 women in the Women's Interagency HIV Study (WIHS) and 4274 men in the Multicenter AIDS Cohort Study (MACS), all with a history of cigarette smoking, were analyzed. Lung cancer incidence rates and incidence rate ratios were calculated using Poisson regression analyses. Survival time was assessed using Kaplan' Meier and Cox proportional-hazard analyses. Results: Thirty-seven women and 23 men developed lung cancer (46 HIV-infected and 14 HIV-uninfected) during study follow-up. In multivariable analyses, the factors that were found to be independently associated with a higher lung cancer incidence rate ratios were older age, less education, 10 ormore pack-years of smoking, and a prior diagnosis of AIDS pneumonia (vs. HIV-uninfected women). In an adjusted Cox model that allowed different hazard functions for each cohort, a history of injection drug use was associated with shorter survival, and a lung cancer diagnosis after 2001 was associated with longer survival. In an adjusted Cox model restricted to HIV-infected participants, nadir CD4 lymphocyte cell count less than 200 was associated with shorter survival time. Conclusions: Our data suggest that pulmonary damage and inflammation associated with HIV infection may be causative for the increased risk of lung cancer. Encouraging and assisting younger HIV-infected smokers to quit and to sustain cessation of smoking is imperative to reduce the lung cancer burden in this population.

Original languageEnglish (US)
Pages (from-to)1183-1193
Number of pages11
JournalAIDS
Volume29
Issue number10
DOIs
StatePublished - Jun 19 2015

Keywords

  • AIDS
  • HIV infection
  • Incidence
  • Lung cancer
  • Survival

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

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