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Department of Oncology, Chelsea & Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK.
There is an increasing awareness of the importance of non-AIDS-defining malignancies occurring in HIV-seropositive people since the introduction of highly active antiretroviral therapy (HAART). Amongst these tumours, lung cancer occurs at an increased frequency compared to age- and gender-matched populations and this increase is not accounted for by smoking alone. Moreover, the incidence of lung cancer in people with HIV is rising as overall survival improves due to HAART. The development of lung cancer is not associated with a low CD4 cell count, suggesting that immune function has a less central role in these tumours than in Kaposi's sarcoma and primary cerebral lymphomas. Most patients present with advanced stage lung cancer and the outcome is very poor. In contrast to the AIDS-defining malignancies, the prognosis in HIV-associated lung cancer does not appear to be improving in the era of HAART. Thus lung cancer and possibly other non-AIDS-defining malignancies may become an increasingly frequent problem whose prognosis has not improved in the era of HAART.
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