Elderly Cancer Patients Who Are HIV-Positive Have Higher Mortality Rates

The findings of a recent JAMA Oncology study suggest that elderly human immunodeficiency (HIV) patients with cancer, particularly breast and prostate cancer, have worse outcomes compared to HIV-negative patients of the same age.

To conduct this study, researchers used a combination of Surveillance, Epidemiology, and End Results-Medicare Linked data to discern 308,268 (168,998 men, 139,270 women) individuals 65 years and older in the US. The population of interest comprised 288 HIV-positive patients with nonadvanced colorectum, lung, prostate, and breast cancer who were diagnosed between 1996 and 2012 and who received standard, stage-appropriate cancer therapy throughout the year subsequent to diagnosis. The exposures in this study were defined as HIV infection listed in Medicare claims, and the key outcomes were overall mortality, and cancer-specific mortality following initial therapy. The researchers performed data analysis from August 2016 to September 2018.

According to the results of the study, HIV-positive patients had appreciably higher levels of overall mortality when juxtaposed with HIV-negative patients with colorectum cancer (HR=1.73; 95% CI, 1.11 to 2.68; P = .02), prostate cancer (HR=1.58; 95% CI, 1.23 to 2.03; P < .01), and breast cancer (HR=1.50; 95% CI, 1.01 to 2.24; P = .05). The results also showed that cancer-specific mortality was heightened for prostate cancer (HR=1.65; 95% CI, 0.98 to 2.79; P = .06) and breast cancer (HR=1.85; 95% CI, 0.96 to 3.55; P = .07). Moreover, when compared with individuals without HIV, both the group of HIV-infected men with prostate cancer and HIV-positive women with breast cancer experienced notably higher rates of cancer relapse or mortality (HR=1.32; 95% CI, 1.03 to 1.71; P = .03), and (HR, 1.63; 95% CI, 1.09-2.43; P = .02), respectively.

Results Stress the Need for More Research

“Previous studies have shown that HIV-infected cancer patients are more likely to die from their cancer than HIV-uninfected cancer patients,” stated Anna E. Coghill, Ph.D., M.P.H., assistant member of the Cancer Epidemiology Department at H.Lee Moffitt Cancer Center & Research Institute in a press release. “However, those studies have not been able to take into account detailed information on the treatments patients may have received, including the exact type or timing of treatment.”

Dr. Coghill continued by saying that “as the HIV population continues to age, the association of HIV infection with poor breast and prostate cancer outcomes will become more important, especially because prostate cancer is projected to become the most common malignancy in the HIV population by 2020. It is why we are stressing the need for more research on clinical strategies to improve outcomes for HIV-infected cancer patients.”

Source: JAMA Oncology, EurekAlert