Anna E. Coghill, PhD, from the National Cancer Institute in Rockville, Maryland, and colleagues examined the effect of HIV on cancer-specific mortality. Cases of 14 common cancers were identified in six U.S. states participating in a linkage of cancer and HIV/AIDS registries. Data were included for 1,816,461 patients with cancer, of whom 0.36% were HIV positive.
Compared to patients without the disease, the researchers found that patients with HIV had significantly elevated cancer-specific mortality for many cancers: colorectum (adjusted hazard ratio [aHR], 1.49), pancreas (aHR, 1.71), larynx (aHR, 1.62), lung (aHR, 1.28), melanoma (aHR, 1.72), breast (aHR, 2.61), and prostate (aHR, 1.57).
For anal cancer, Hodgkin’s lymphoma, or diffuse large B-cell lymphoma, HIV was not associated with increased cancer-specific mortality. HIV remained associated with elevated cancer-specific mortality in non-AIDS-defining cancers: colorectum, lung, melanoma, and breast cancers (aHRs, 1.40, 1.28, 1.93, and 2.64), after further adjustment for cancer treatment.
“The elevation in cancer-specific mortality among HIV-infected patients may be attributable to unmeasured stage or treatment differences as well as a direct relationship between immunosuppression and tumor progression,” the researchers wrote.