Human immunodeficiency virus and lung cancer

The association of human immunodeficiency virus (HIV) infection with lung cancer remains unclear. The presence of multiple risk factors in patients with HIV infection makes it difficult to identify a direct cause-effect relationship. A retrospective study of patients with lung cancer who were diagnosed, treated and followed at Harlem Hospital Center, New York, between January 1990 and December 1994 was performed. Eleven HIV-seropositive and 116 HIV-indeterminate patients with histologically proven lung cancer were identified. The two groups were compared with regard to age, sex, race, predisposing factors, stage of presentation, histological type of the tumours and survival. HIV-infected patients with lung cancer were predominantly male smokers who were significantly younger than the control HIV-indeterminate patients with lung cancer. Although adenocarcinoma was seen more frequently in the HIV-seropositive group, the difference was not statistically significant. Survival in HIV-infected patients was shorter than that in HIV-indeterminate patients, suggesting that the cancer may be more aggressive in HIV-infected patients or that the progression of immunoincompetence in these patients may influence survival. A direct cause-effect relationship between lung cancer and HIV infection is difficult to establish in the presence of other risk factors, but the incidence of lung cancer may be increasing in HIV-infected men.