{"id":10256,"date":"2010-04-02T13:20:50","date_gmt":"2010-04-02T13:20:50","guid":{"rendered":"http:\/\/i-base.info\/htb\/?p=10256"},"modified":"2013-08-07T09:13:38","modified_gmt":"2013-08-07T09:13:38","slug":"hiv-increases-the-risk-of-lung-cancer-independent-of-smoking-status","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/10256","title":{"rendered":"HIV increases the risk of lung cancer, independent of smoking status"},"content":{"rendered":"

Simon Collins, HIV\u00a0i-Base<\/strong><\/p>\n

Keith Sigel and colleagues presented an analysis from the US Veterans Ageing Cohort Study Virtual Cohort (VC) on the relationship between HIV and lung cancer. [1]<\/strong><\/p>\n

The advantages of this database included size, smoking status data from a related health survey and a matched HIV-negative control group, although this was an almost exclusively (98%) male study. Median age was 47 years and ethnicity was approximately 40% white, 40% black. 10% Hispanic and 10% other. Approximately 30% were current smokers, 15% recently quit (< 1 year), 25-50% distantly quit (> 1 year) and 20% of HIV-positive compared to 25% of HIV-negative had never smoked.<\/p>\n

The analysis compared over 3,700 HIV-positive and nearly 10,000 HIV negative patients (contributing 28,500 and 76,800 person-years of follow-up respectively).<\/p>\n

Lung cancer was defined using International Classification of Diseases (ICD-9) codes and Incidence Rate Ratios (IRR) were adjusted for age, race, smoking exposure, and Chronic Obstructive Pulmonary Disease (COPD).<\/p>\n

The overall incidence of lung cancer per 100 person years was 0.26 compared to 0.16 in the HIV positive vs HIV negative groups (unadjusted IRR 1.5, 95%CI 1.2\u20132.0). Results from the adjusted analysis are detailed in Table 1.<\/p>\n

Table 1: Adjusted IRR for lung cancer multivariate model including all covariates<\/strong><\/p>\n\n\n\n\n\n\n\n\n
Variable<\/td>\nIRR<\/td>\n95% CI<\/td>\n<\/tr>\n
HIV infection<\/td>\n1.8<\/td>\n1.3\u20132.4<\/td>\n<\/tr>\n
Age<\/td>\n1.1<\/td>\n1.1\u20131.1<\/td>\n<\/tr>\n
Race\/ethnicity: *African-American\n

Hispanic<\/p>\n

Other<\/p><\/td>\n

0.9\n

0.4<\/p>\n

0.9<\/p><\/td>\n

0.7\u20131.2\n

0.2\u20130.8<\/p>\n

0.5\u20131.6<\/p><\/td>\n<\/tr>\n

COPD<\/td>\n1.5<\/td>\n1.1\u20132.1<\/td>\n<\/tr>\n
Smoking exposure: **Current daily smoker\n

Current occasional smoker<\/p>\n

Recently quit smoking (<1 yr)<\/p>\n

Distantly quit smoking (>1 yr)<\/p><\/td>\n

9.8\n

3.4<\/p>\n

9.9<\/p>\n

5.1<\/p><\/td>\n

4.4\u201321.4\n

1.0\u201311.6<\/p>\n

4.4\u201322.3<\/p>\n

2.4\u201311.2<\/p><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

* Reference = white race; ** Reference = never smoked.<\/p>\n

The authors concluded that the incidence of lung cancer was significantly increased in HIV-positive men in their group, even after adjusting for smoking exposure.<\/p>\n

comment<\/strong><\/h3>\n

This study reported slightly lower rates of increased risk of lung cancers in HIV positive individuals\u00a0compared to rates that were 2- to 6-fold higher in earlier studies, that also adjusted for smoking status. [2, 3, 4]<\/strong><\/p>\n

While the approximate 2-fold increased risk associated with HIV was significant and is important, the presenter emphasised the 10-fold higher risk\u00a0for current smokers (that was halved to around 5-fold for former smokers who had quit more than one year earlier).<\/strong><\/p>\n

References<\/p>\n

Unless stated otherwise, all references are to the Programme and Abstracts of the 17th Conference on Retroviruses and Opportunistic Infections. 16-10\u00a0February 2010, San Francisco. All oral abstracts are available as webcasts.
\nhttp:\/\/www.retroconference.org<\/a><\/p>\n

    \n
  1. Sigel K et al. HIV infection is an independent risk factor for lung cancer. 17th CROI, 2010. Oral Abstract 30.
    \n    http:\/\/www.retroconference.org\/2010\/Abstracts\/38365.htm<\/a><\/li>\n
  2. Cadranel J et al. Lung cancer in HIV infected patients: facts, questions and challenges. Thorax 2006; 61:1000-1008.
    \n    http:\/\/thorax.bmj.com\/content\/61\/11\/1000.abstract<\/a><\/li>\n
  3. Engels EA et al. Elevated incidence of lung cancer among HIV-infected individuals. J Clin Oncol 2006; 24 (9); 1383-1388. (March 2006).
    \n    http:\/\/jco.ascopubs.org\/cgi\/content\/abstract\/24\/9\/1383<\/a><\/li>\n
  4. Kirk GD et al. HIV infection is associated with an increased risk for lung cancer, independent of smoking. Clin Inf Dis 2007; 45:103-110.
    \n    http:\/\/www.journals.uchicago.edu\/doi\/abs\/10.1086\/518606<\/a><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Simon Collins, HIV\u00a0i-Base Keith Sigel and colleagues presented an analysis from the US Veterans Ageing Cohort Study Virtual Cohort (VC) on the relationship between HIV and lung cancer. [1] The advantages of this database included size, smoking status data from …<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,18],"tags":[64],"class_list":["post-10256","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-cancer-and-hiv","tag-croi-2010"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/10256","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=10256"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/10256\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=10256"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=10256"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=10256"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}