Key clinical point: In the US, elderly patients with HIV and cancer, particularly prostate and breast cancers, have worse outcomes than HIV-uninfected patients with cancer.
Major finding: Compared with their HIV-uninfected counterparts, HIV-infected men with prostate cancer also experienced significantly higher rates of relapse or death.
Study details: Surveillance, Epidemiology, and End Results-Medicare linked data was used to identify 308,268 patients aged ≥65 years in the US, including 288 with HIV infection, with nonadvanced cancers of the colorectum, lung, prostate, or breast diagnosed between 1996-2012 who received standard, stage-appropriate cancer treatment during the year after diagnosis.
Coghill AE, et al. JAMA Oncol. 2019 Aug 1. doi: 10.1001/jamaoncol.2019.1742.
The association between HIV and cancer has been recognized since early after the discovery of HIV. However, the strength of these associations for some cancers has been unclear for some time. The understanding of the relationship between the immune system and prostate cancer is advancing since the recent upswing in use of immunotherapy across different malignancies. Based on these findings and the fact that many patients with prostate cancer also have HIV, the accompanying findings that the mortality rate for prostate cancer patients with HIV is higher than those without HIV supports further study into the mechanism of the association. —Mark A. Klein, MD