2240. Characteristics of Lung Cancer Treatment in Recent ART-era HIV+ Patients. (26th November 2018)

• Record Type: Journal Article
• Authors: Kobayashi, Takaaki; Stone, Kimberly; Sigel, Keith
• Is Part Of: Open forum infectious diseases. Volume 5(2018)Supplement 1
• Page Start: S662
• Page End: S663
• Publication Date: 2018-11-26
• Subjects: Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofy210.1893
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background: Human immunodeficiency virus (HIV) infection is independently associated with lung cancer risk. Due to the aging of the U.S. HIV+ cohort, a high prevalence of smoking and lower rates of HIV-related mortality, lung cancer is now a major source of mortality in this group. Little is known about the tolerability of lung cancer treatment in HIV+ persons in the recent antiretroviral therapy (ART) era. Methods: We identified 84 HIV+ patients and 48 uninfected comparators (matched by age, sex and cancer stage) who were diagnosed with lung cancer between 2006 and 2017 in our New York health system and collected data on treatment of HIV and treatment of lung cancer as well as adverse outcomes from electronic medical charts. We then compared characteristics, treatments and adverse treatment outcomes for HIV+ patients and controls. Results: Subjects did not differ by HIV status in regards to age and sex (both P > 0.3) but HIV+ were more likely to be black or Hispanic and less likely to be white ( P = 0.001). The prevalence of most major comorbidities did not differ by HIV status although chronic kidney disease and chronic hepatitis C infection were more common in HIV group ( P = 0.001). There was no difference in histologic subtype or cancer stage of lung cancer by HIV status. Surgery was performed in 65% of HIV+ and 78% of uninfected patients that were stages I-IIIA ( P = 0.4). Radiosurgery was performed in 8% of stage I HIV+ compared with no uninfected patients ( P = 0.04). Chemotherapy was administered less frequently in HIV+ patients; 44% vs. 62% ( P = 0.04). The most frequent chemotherapy complication for HIV+ patients was early chemotherapy termination (44%; P = 0.1) with a trend toward more frequent dehydration and fever in HIV+ patients (all P = 0.1 for comparisons to uninfected). Other chemotherapy complications in HIV+ patients included nausea (25%), anemia (11%), neutropenia (11%), diarrhea (11%), and thrombocytopenia (8%; all p>0.05 for comparisons with uninfected). Conclusion: In our cohort from the recent ART-era we found some lung cancer treatment disparities in HIV+ patients. We found no major differences in chemotherapy toxicity associated with HIV status. Future research should further evaluate barriers to optimal lung cancer care within the HIV+ population. Disclosures: All authors: No reported disclosures.