The associations of CD4 count, CD4/CD8 ratio, and HIV viral load with survival from non-small cell lung cancer in persons living with HIV

ABSTRACT

HIV status may influence survival from non-small cell lung cancer (NSCLC). Among NSCLC patients in the Bronx, NY, we assessed (1) associations of CD4 count, CD4/CD8 ratio and HIV viral load (VL) with survival and (2) prognostic factors among persons living with HIV (PLWH). We compared survival from NSCLC diagnosis (2004–2017) between HIV-negative persons (HIV-, n=2,881) and PLWH (n=88) accounting for clinical and sociodemographic factors. HIV-survival was also compared with PLWH, dichotomized by CD4 (<200 vs. ≥200cells/µL), CD4/CD8 (median, <0.43 vs. ≥0.43) and VL (<75 vs. ≥75copies/mL) at NSCLC diagnosis. Among PLWH, we assessed the relationships of CD4, CD4/CD8, and VL with survival, adjusting for age, sex, and cancer stage. PLWH with CD4< 200cells/µL had lower survival than HIV- [hazard ratio, 95% confidence interval [HR(95%CI)]=1.86(0.98–3.55)]. Survival was similar between PLWH with CD4≥ 200cells/µL and HIV- [HR(95%CI) = 0.90(0.61–1.33)]. Results were similar when categorizing PLWH by CD4/CD8 [vs. HIV-: low CD4/CD8: HR(95%CI) = 1.74(1.07–3.89); high CD4/CD8: HR(95%CI) = 0.63(0.37–1.07)] and VL [vs. HIV-: <75copies/mL: HR(95%CI) = 0.74(0.46–1.21), ≥75copies/mL: HR(95%CI) = 1.41(0.88–2.27)]. Among PLWH, CD4< 200cells/µL was associated with worse survival [vs. CD4≥ 200cells/µL: HR(95%CI) = 2.37(1.14–4.92)]. CD4, CD4/CD8, and VL may be prognostic markers for PLWH with NSCLC, suggesting immune status may be important in NSCLC survival among PLWH.

KEYWORDS:

• Lung cancer
• CD4 count
• viral load
• mortality
• AIDS

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by NIH/National Center for Advancing Translational Science (NCATS) Einstein-Montefiore CTSA Grant Number UL1TR001073. The Einstein-Rockefeller-CUNY Center for AIDS Research (P30-AI-124414) is supported by the following NIH Co-Funding and Participating Institutes and Centers: NIAID, National Cancer Institute (NCI); National Institute of Child Health and Human Development (NICHD); National Heart, Lung, and Blood Institute (NHLBI); National Institute on Drug Abuse (NIDA); National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); National Institute of General Medical Sciences (NIGMS); National Institute of Mental Health (NIMH); National Institute on Minority Health and Health Disparities (NIMHD); National Institute on Aging (NIA); Fogarty International Center (FIC); and Office of AIDS Research (OAR). Work by BH was supported by 5UG1CA189859-07, 3P30CA013330-48S1. DBH was supported by K01-HL-137557.