The relative incidence and rate of lung cancer in HIV-infected patients compared with the general US population has been a source of controversy. We sought to establish these parameters in a cohort of 2616 HIV-infected patients. Tumour type, stage of disease, patient demographics and immune parameters including viral loads were ascertained. An annual rate of 191 cases/100,000 population was found, which is 3.01 times greater (95% confidence interval [CI]=1.3-7.0) when compared with the general US population and 7.4 times the rate in US males between ages 35 and 54 (95% CI=3.1-17.8). Three patients had CD4 counts greater than 200 cells/mm3 at diagnosis and 2 had undetectable viral loads. The mean age was 44 years and all had advanced disease and short survival. In conclusion, the incidence of primary lung cancer was increased in this cohort of HIV-infected patients and occurred over a wide range of immunosuppression and viral replication.
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