Human immunodeficiency virus infection and mortality risk among lung cancer patients: A systematic review and meta-analysis

Yue-Hua Wang, Xiang-Di Shen, Yue-Hua Wang, Xiang-Di Shen

Abstract

Background: Previous studies have suggested that patients with human immunodeficiency virus (HIV) infection are at higher risk of lung cancer, but the impact of HIV infection on the risk of mortality among lung cancer patients is still unclear. We conducted a systematic review and meta-analysis to clarify the association between HIV infection and mortality risk among lung cancer patients.

Methods: PubMed and Embase databases were searched to identify studies assessing the association between HIV infection and mortality risk among lung cancer patients. Only studies reporting adjusted relative risk (RR) of mortality among lung cancer patients with HIV infection were included. Meta-analysis of random-effect model was utilized to calculate the pooled RR with 95% confidence interval (CI).

Results: Twelve cohort studies were finally included. Compared with lung cancer patients without HIV infection, the pooled RR of mortality among lung cancer patients with HIV infection was 1.48 (95% CI, 1.22-1.78, P < .001; I = 88.6%). After excluding 2 studies with low quality, HIV infection was still significantly associated with an elevated risk of mortality among lung cancer patients (RR = 1.51, 95% CI, 1.25-1.82, P < .001; I = 89.8%). Sensitivity analysis showed that the statistical significance of the pooled RR was not changed by excluding any one study.

Conclusion: The outcomes from the meta-analysis provide strong evidence for the elevated risk of mortality among lung cancer patients with HIV infection, and HIV infection is an important prognostic factor in lung cancer patients.

Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Meta-analysis of total 12 studies suggested an elevated risk of mortality among lung cancer patients with HIV infection.
Figure 2
Figure 2
Forest plot in the subgroup analysis stratified by histological type of lung cancer.
Figure 3
Figure 3
Forest plot in the meta-analysis of 10 studies with high quality.
Figure 4
Figure 4
Forest plot showed the outcomes of sensitivity analyses by removing one study at a time.
Figure 5
Figure 5
Funnel plot in the meta-analysis of total 12 included studies.

References

    1. Torre LA, Siegel RL, Jemal A. Lung cancer statistics. Adv Exp Med Biol 2016;893:1–9.
    1. Mao Y, Yang D, He J, et al. Epidemiology of lung cancer. Surg Oncol Clin N Am 2016;25:439–45.
    1. Malhotra J, Malvezzi M, Negri E, et al. Risk factors for lung cancer worldwide. Eur Respir J 2016;48:889–902.
    1. Badyda AJ, Grellier J, Dabrowiecki P. Ambient PM2.5 exposure and mortality due to lung cancer and cardiopulmonary diseases in Polish cities. Adv Exp Med Biol 2017;944:9–17.
    1. Costa G, Thuler LC, Ferreira CG. Epidemiological changes in the histological subtypes of 35,018 non-small-cell lung cancer cases in Brazil. Lung Cancer 2016;97:66–72.
    1. Sigel K, Wisnivesky J, Crothers K, et al. Immunological and infectious risk factors for lung cancer in US veterans with HIV: a longitudinal cohort study. Lancet HIV 2017;4:e67–73.
    1. Marcus JL, Leyden WA, Chao CR, et al. Immunodeficiency, AIDS-related pneumonia, and risk of lung cancer among HIV-infected individuals. AIDS 2017;31:989–93.
    1. Kadara H, Scheet P, Wistuba II, et al. Early events in the molecular pathogenesis of lung cancer. Cancer Prev Res (Phila) 2016;9:518–27.
    1. Hong S, Mok Y, Jeon C, et al. Tuberculosis, smoking and risk for lung cancer incidence and mortality. Int J Cancer 2016;139:2447–55.
    1. Soria JC, Tan DS, Chiari R, et al. First-line ceritinib versus platinum-based chemotherapy in advanced ALK-rearranged non-small-cell lung cancer (ASCEND-4): a randomised, open-label, phase 3 study. Lancet 2017;389:917–29.
    1. Saavedra D, Garcia B, Lage A. T cell subpopulations in healthy elderly and lung cancer patients: insights from Cuban studies. Front Immunol 2017;8:146.
    1. Wallington M, Saxon EB, Bomb M, et al. 30-day mortality after systemic anticancer treatment for breast and lung cancer in England: a population-based, observational study. Lancet Oncol 2016;17:1203–16.
    1. Eberle A, Jansen L, Castro F, et al. Lung cancer survival in Germany: a population-based analysis of 132,612 lung cancer patients. Lung Cancer 2015;90:528–33.
    1. Dehne KL, Dallabetta G, Wilson D, et al. HIV prevention 2020: a framework for delivery and a call for action. Lancet HIV 2016;3:e323–32.
    1. Justman J, Reed JB, Bicego G, et al. Swaziland HIV Incidence Measurement Survey (SHIMS): a prospective national cohort study. Lancet HIV 2017;4:e83–92.
    1. Thorne C, Tookey P. Strategies for monitoring outcomes in HIV-exposed uninfected children in the United Kingdom. Front Immunol 2016;7:185.
    1. Thao C, Shorr AF, Woods C. Non-infectious pulmonary disorders in HIV. Expert Rev Respir Med 2017;11:209–20.
    1. Singh E, Naidu G, Davies MA, et al. HIV-associated malignancies in children. Curr Opin HIV AIDS 2017;12:77–83.
    1. Hasson H, Merli M, Messina E, et al. Occurrence of hepatocellular carcinoma in HIV/HCV co-infected patients treated with direct-acting antivirals. J Hepatol 2017.
    1. Chinula L, Moses A, Gopal S. HIV-associated malignancies in sub-Saharan Africa: progress, challenges, and opportunities. Curr Opin HIV AIDS 2017;12:89–95.
    1. Yanik EL, Katki HA, Engels EA. Cancer risk among the HIV-infected elderly in the United States. AIDS 2016;30:1663–8.
    1. Sigel K, Makinson A, Thaler J. Lung cancer in persons with HIV. Curr Opin HIV AIDS 2017;12:31–8.
    1. Kiderlen TR, Siehl J, Hentrich M. HIV-associated lung cancer. Oncol Res Treat 2017;40:88–92.
    1. Zaenker P, Gray ES, Ziman MR. Autoantibody production in cancer—the humoral immune response toward autologous antigens in cancer patients. Autoimmun Rev 2016;15:477–83.
    1. Yanik EL, Kaunitz GJ, Cottrell TR, et al. Association of HIV status with local immune response to anal squamous cell carcinoma: implications for immunotherapy. JAMA Oncol 2017;3:974–8.
    1. Dryden-Peterson S, Bvochora-Nsingo M, Suneja G, et al. HIV infection and survival among women with cervical cancer. J Clin Oncol 2016;34:3749–57.
    1. Marcus JL, Chao C, Leyden WA, et al. Survival among HIV-infected and HIV-uninfected individuals with common non-AIDS-defining cancers. Cancer Epidemiol Biomarkers Prev 2015;24:1167–73.
    1. Coghill AE, Shiels MS, Suneja G, et al. Elevated cancer-specific mortality among HIV-infected patients in the United States. J Clin Oncol 2015;33:2376–83.
    1. Suneja G, Shiels MS, Melville SK, et al. Disparities in the treatment and outcomes of lung cancer among HIV-infected individuals. AIDS 2013;27:459–68.
    1. Sigel K, Crothers K, Dubrow R, et al. Prognosis in HIV-infected patients with non-small cell lung cancer. Br J Cancer 2013;109:1974–80.
    1. Rengan R, Mitra N, Liao K, et al. Effect of HIV on survival in patients with non-small-cell lung cancer in the era of highly active antiretroviral therapy: a population-based study. Lancet Oncol 2012;13:1203–9.
    1. Shiels MS, Cole SR, Mehta SH, et al. Lung cancer incidence and mortality among HIV-infected and HIV-uninfected injection drug users. J Acquir Immune Defic Syndr 2010;55:510–5.
    1. Brock MV, Hooker CM, Engels EA, et al. Delayed diagnosis and elevated mortality in an urban population with HIV and lung cancer: implications for patient care. J Acquir Immune Defic Syndr 2006;43:47–55.
    1. Tammemagi CM, Neslund-Dudas C, Simoff M, et al. Impact of comorbidity on lung cancer survival. Int J Cancer 2003;103:792–802.
    1. Hartling L, Milne A, Hamm MP, et al. Testing the Newcastle Ottawa Scale showed low reliability between individual reviewers. J Clin Epidemiol 2013;66:982–93.
    1. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials 1986;7:177–88.
    1. Cochran WG. The combination of estimates from different experiments. Biometrics 1954;10:101–29.
    1. Higgins J, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med 2002;21:1539–58.
    1. Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics 1994;50:1088–101.
    1. Egger M, Smith GD, Phillips AN. Meta-analysis: principles and procedures. BMJ 1997;315:1533–7.
    1. Hessol NA, Martinez-Maza O, Levine AM, et al. Lung cancer incidence and survival among HIV-infected and uninfected women and men. AIDS 2015;29:1183–93.
    1. Maso LD, Suligoi B, Franceschi S, et al. Survival after cancer in Italian persons with AIDS, 1986-2005: a population-based estimation. J Acquir Immune Defic Syndr 2014;66:428–35.
    1. Lee JY, Moore PC, Steliga MA. Do HIV-infected non-small cell lung cancer patients receive guidance-concordant care? Med Care 2013;51:1063–8.
    1. Hooker CM, Meguid RA, Hulbert A, et al. Human immunodeficiency virus infection as a prognostic factor in surgical patients with non-small cell lung cancer. Ann Thorac Surg 2012;93:405–12.
    1. Hleyhel M, Belot A, Bouvier AM, et al. Trends in survival after cancer diagnosis among HIV-infected individuals between 1992 and 2009. Results from the FHDH-ANRS CO4 cohort. Int J Cancer 2015;137:2443–53.
    1. Gotti D, Raffetti E, Albini L, et al. Survival in HIV-infected patients after a cancer diagnosis in the cART Era: results of an Italian multicenter study. PLoS One 2014;9:e94768.
    1. Achenbach CJ, Cole SR, Kitahata MM, et al. Mortality after cancer diagnosis in HIV-infected individuals treated with antiretroviral therapy. AIDS 2011;25:691–700.
    1. Lavole A, Chouaid C, Baudrin L, et al. Effect of highly active antiretroviral therapy on survival of HIV infected patients with non-small-cell lung cancer. Lung Cancer 2009;65:345–50.
    1. Powles T, Thirwell C, Newsom-Davis T, et al. Does HIV adversely influence the outcome in advanced non-small-cell lung cancer in the era of HAART? Br J Cancer 2003;89:457–9.
    1. Spina M, Sandri S, Serraino D, et al. Therapy of non-small-cell lung cancer (NSCLC) in patients with HIV infection. GICAT. Cooperative Group on AIDS and Tumors. Ann Oncol 1999;10(Suppl. 5):S87–90.
    1. Vyzula R, Remick SC. Lung cancer in patients with HIV-infection. Lung Cancer 1996;15:325–39.
    1. Sridhar KS, Flores MR, Raub WA, Jr, et al. Lung cancer in patients with human immunodeficiency virus infection compared with historic control subjects. Chest 1992;102:1704–8.
    1. Mortaz E, Tabarsi P, Mansouri D, et al. Cancers related to immunodeficiencies: update and perspectives. Front Immunol 2016;7:365.
    1. Lee JY, Dhakal I, Casper C, et al. Risk of cancer among commercially insured HIV-infected adults on antiretroviral therapy. J Cancer Epidemiol 2016;2016:2138259.
    1. Silverberg MJ, Lau B, Achenbach CJ, et al. Cumulative incidence of cancer among persons with HIV in North America: a cohort study. Ann Intern Med 2015;163:507–18.
    1. Sigel K, Pitts R, Crothers K. Lung malignancies in HIV infection. Semin Respir Crit Care Med 2016;37:267–76.
    1. Ruck C, Reikie BA, Marchant A, et al. Linking susceptibility to infectious diseases to immune system abnormalities among HIV-exposed uninfected infants. Front Immunol 2016;7:310.
    1. Cunha BM, Mota LM, Pileggi GS, et al. HIV/AIDS and rheumatoid arthritis. Autoimmun Rev 2015;14:396–400.
    1. Rossouw TM, Anderson R, Feldman C. Impact of HIV infection and smoking on lung immunity and related disorders. Eur Respir J 2015;46:1781–95.

Source: PubMed

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

3
Abonneren