Lung cancer and HIV

Abstract

People, living with HIV, have a greater chance of malignancies especially with the success of antiretroviral therapy, and Non-AIDS-defining cancers have become the most common cause of death after AIDS and the most common of them is the lung cancer in developed countries. The main purpose of this article is to research nosological characteristics of lung cancer in the context of HIV infection, HIV-associated risk factors during ART and compare with global trends of this problem. Retrospectively were analyzed the medical documentation of 98 patients with lung cancer and HIV-infection, who were in database and received specialized treatment in St. Petersburg from 2008 to 2018 years. There are several important questions regarding to lung cancer with HIV-infection. HIV-infected lung cancer patients are younger than HIV-negative, have a more advanced disease and that is more difficult to treat. The increased risk of lung cancer in HIV-positive population is multifactorial. The population was dominated by patients of young (18-44 years old) and middle (45-59 years old) ages, 45.9% and 42.9%, respectively, and 11.2% of elderly patients (60-74 years old), p0.001, which satisfies the global data of earlier incidence of lung cancer in people living with HIV. Adenocarcinomas were more common histological subtype of lung cancer as in the general population (p0.001). There was no static significance between high viral load and lung cancer, which can indicate the absence of a direct mechanism of HIV-carcinogenesis (90.8% of patients with low and medium viral load, p0.001).Nevertheless, the prevalence of 4-stage of HIV infection among lung cancer patients (p0.001) indicates a history of inflammatory diseases, including pulmonary diseases, as a result of induced immunosuppression due to CD8+T-lymphocyte dysfunction and the formation of a micro-tumor environment, which can be a prognostic unfavorable factor in the occurrence of lung cancer in this group of patients , as well as indirect mechanism of viral carcinogenesis. The presence of elderly patients (11.2%, MAX -71 years) indirectly indicates an increasing of period of life expectancy among this category of patients in Russia, making this area of research more actual.