Immunodeficiency, AIDS-related pneumonia, and risk of lung cancer among HIV-infected individuals

The objective is to clarify the role of immunodeficiency and pneumonia in elevated lung cancer risk among HIV-infected individuals. Design: Cohort study of HIV-infected and HIV-uninfected adults in a large integrated healthcare system in California during 1996–2011. Methods: We used Poisson models to obtain rate ratios for lung cancer associated with HIV infection, overall and stratified by recent CD4+ cells/μl (HIV-uninfected as reference group), with χ2 tests for trends across CD4+ strata. Fully adjusted models included demographics, cancer risk factors (smoking, drug/alcohol abuse, overweight/obesity), and prior pneumonia. Results: Among 24 768 HIV-infected and 257 600 HIV-uninfected individuals, the lung cancer rate per 100 000 person-years was 66 (n = 80 events) for HIV-infected and 33 (n = 506 events) for HIV-uninfected individuals [rate ratio 2.0, 95% confidence interval (CI): 1.7–2.2]. Overall, HIV-infected individuals were at increased risk of lung cancer after adjustment for demographics and cancer risk factors (rate ratio 1.4, 95% CI: 1.1–1.7), but not after additional adjustment for pneumonia (rate ratio 1.2, 95% CI: 0.9–1.6). Lower CD4+ cell counts were associated with higher risk of lung cancer in unadjusted and demographics-adjusted models (P 
Source: AIDS - Category: Infectious Diseases Tags: Clinical Science: Concise Communication Source Type: research