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Lung Cancer in HIV Patients: A Case Series and Literature Review

Zarate, Hernan MD; Lippmann, Michael MD

doi: 10.1097/CPM.0b013e318299142e
Topics in Pulmonary Medicine

Background: The widespread use of highly active antiretroviral therapy has lead to the reporting of non-AIDS–defining tumors in HIV-infected individuals. Within this group, lung cancer is the most commonly reported.

Objective: To describe the characteristics, clinical features, outcomes, and factors associated with survival in patients with lung cancer and HIV infection.

Methods: This is a retrospective chart review of adult patients found to have lung cancer and HIV/AIDS admitted to Einstein Medical Center between 2000 and 2010.

Results: A total of 27 patients were included. Patients had a median age of 47 years (range, 34 to 75 y), were predominantly male (60%) and smokers (93%). The most frequent histologic type was adenocarcinoma (67%). Stage III to IV disease was observed in 92% of the patients. At diagnosis of lung cancer, 85% of the patients already had AIDS-defining manifestations. The median CD4 count was 260 cells/mm3 and the median viral load for 17 assessable patients was 400 copies/mL. Twenty-six patients received specific treatment for their lung cancer. Most of them received medical therapy, and 5 patients underwent surgery. The median survival was 8.1 months. Poor performance status (PS) and advanced stage of lung cancer were associated with poor outcomes.

Conclusions: HIV-infected patients with lung cancer were young, male, smokers, usually with adenocarcinomas, presented with advanced disease and had poor PS. Prognosis was in general poor. As in the general population, surgery remains the only curative treatment modality for lung cancer in HIV-infected individuals. Poor PS and advanced stage of lung cancer are associated with poor outcomes.

Division of Pulmonary and Critical Care Medicine, Einstein Medical Center, Philadelphia, PA

This study was performed in entirety at the Einstein Medical Center, Philadelphia, PA.

The authors declare that they have nothing to disclose.

Address correspondence to: Michael Lippman, MD, Division of Pulmonary and Critical Care Medicine, Einstein Medical Center, 5501 Old York Road, Philadelphia, PA 19141. E-mail:

© 2013 by Lippincott Williams & Wilkins, Inc.