HIV accelerates the development and progression of lung cancer: a single-centre prospective study

Evidence suggest that the risk for lung cancer in people living with human immunodeficiency virus (PLHIV) is higher than the general population. South Africa remains the country with one of the highest number of PLHIV. Given the high burden of disease for both HIV and lung cancer in our population, the objective of our study was to compare various characteristics of PLHIV and HIV-negative patients with lung cancer. The cohort consisted of 1805 patients of which 1129 were male [mean (±Standard Deviation, SD) 60.0 (+10.1) years]. In total 1292 were HIV-negative, whilst 133 were PLHIV; the remainder was categorised as HIV-unknown. PLHIV with lung cancer were found to be younger than the HIV-negative group [mean (±SD) 60.3 (10.1) vs. 54.6 (9.3), p<0.001). Notably, not a single PLHIV (0%) was diagnosed with a curable form of non-small cell lung cancer (NSCLC) at the time of staging (all had stage IIIB to IVB) in comparison to the HIV-negative patients, where 66 of 1106 had potentially curable disease (p<0.001). Adenocarcinoma was found to be the most common tissue type in both HIV-negative and HIV-positive groups (46.3% and 39.8%, respectively). Squamous cell carcinoma (SCC) was diagnosed in 33.8% of the HIV-positive group. In conclusion, our study found that PLHIV with lung cancer were diagnosed at a younger age and were significantly less likely to have curable disease at presentation. Further research on mechanisms, not only to mitigate the risk of developing lung cancer but also allow for earlier detection of disease is needed.