LOS ANGELES — HIV-infected persons are now almost as likely to die of lung cancer as they are of non-Hodgkin's lymphoma, and they are more likely to die of lung cancer than of Kaposi's sarcoma, according to a large cohort of patients in developed countries.
Data from a cohort of 23,437 HIV-infected individuals followed since 1999 show that HIV-infected individuals in developed countries are now more likely to die of a cancer not traditionally associated with AIDS as they are to die of an AIDS-defining cancer, said Dr. Antonella D'Arminio Monforte of the University of Milan.
In the cohort, 193 individuals died from a non-AIDS-defining malignancy while 112 died from an AIDS-defining malignancy. The most common fatal non-AIDS cancer in the cohort was lung cancer (62 deaths), she said at the 14th Conference on Retroviruses and Opportunistic Infections.
The cohort, known as the DAD (Data Collection on Adverse Events of Anti-HIV Drugs) study group, had 82 deaths from non-Hodgkin's lymphoma and 28 deaths from Kaposi's sarcoma. There also were two deaths from cervical cancer, the last of the three AIDS-defining cancers considered in Dr. D'Arminio Monforte's study.
Of the 193 non-AIDS-defining cancer deaths, there were, in addition to the 62 lung cancer deaths (32%), 25 gastrointestinal (13%), 16 liver (8%), 20 hematologic system (10%), and 20 anal cancer deaths (10%). The cancers seen less frequently included 18 urogenital cancers (9%), 9 cancers of the upper airways (5%), and 21 other cancers (11%).
Analysis of the data revealed that heterosexual persons and intravenous drug users had a lower risk of AIDS-defining fatal malignancy than did homosexual males, and both types of cancer were related to the patient's latest CD4 T-cell count.
The association between the CD4 count and fatal malignancy was such that there was a 37% reduction in fatal, AIDS-defining malignancy for every doubling of the CD4 count and a 39% reduction in fatal, non-AIDS-defining malignancy for every doubling of the CD4 count.
The DAD study cohort pools patients from 11 cohorts in Europe, the United States, and Australia.