TY - JOUR
T1 - Effect of body weight and other metabolic factors on risk of non-small cell lung cancer among veterans with hiv and a history of smoking
AU - Garcia, Jose M.
AU - Kramer, Jennifer R.
AU - Richardson, Peter A.
AU - Ahmed, Sarah
AU - Royse, Kathryn E.
AU - White, Donna L.
AU - Raychaudhury, Suchismita
AU - Chang, Elaine
AU - Hartman, Christine M.
AU - Silverberg, Michael J.
AU - Chiao, Elizabeth Y.
N1 - Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2020/12
Y1 - 2020/12
N2 - Among people living with HIV (PWH), there has been an increasing incidence of non-small cell lung cancer (NSCLC) and metabolic abnormalities, including dyslipidemia, which can modulate NSCLC risk. In this article, we evaluate which metabolic risk factors are associated with incident risk among PWH who smoke. This is done through a retrospective cohort study, using data of HIV+ veterans who smoke from the nationwide Veterans Affairs (VA) healthcare system. Data on diagnostic codes, medication, and laboratory values of 33,351 veterans were obtained using the VA’s Corporate Data Warehouse and Central Cancer Registry. We calculated NSCLC incidence and utilized Cox regression to determine metabolic factors associated with NSCLC risk. HIV+ cohort was 97.4% male; median age = 47 years and 20,050 (60.1%) well-controlled (≥80% follow-up time undetectable viral load). Crude incidence rates were lower in well-controlled PWH (1.46 vs. 2.06/1000 PY). Metabolic factors associated with incident NSCLC risk included lower BMI at HIV diagnosis and cachexia history in both groups, while HDL and triglycerides were significant in non-well-controlled smokers only. Our findings that lower BMI at HIV diagnosis, history of cachexia among individuals with well-controlled HIV, and cachexia presence at diagnosis are associated with increased risk of developing NSCLC in PWH with a history of smoking have important implications.
AB - Among people living with HIV (PWH), there has been an increasing incidence of non-small cell lung cancer (NSCLC) and metabolic abnormalities, including dyslipidemia, which can modulate NSCLC risk. In this article, we evaluate which metabolic risk factors are associated with incident risk among PWH who smoke. This is done through a retrospective cohort study, using data of HIV+ veterans who smoke from the nationwide Veterans Affairs (VA) healthcare system. Data on diagnostic codes, medication, and laboratory values of 33,351 veterans were obtained using the VA’s Corporate Data Warehouse and Central Cancer Registry. We calculated NSCLC incidence and utilized Cox regression to determine metabolic factors associated with NSCLC risk. HIV+ cohort was 97.4% male; median age = 47 years and 20,050 (60.1%) well-controlled (≥80% follow-up time undetectable viral load). Crude incidence rates were lower in well-controlled PWH (1.46 vs. 2.06/1000 PY). Metabolic factors associated with incident NSCLC risk included lower BMI at HIV diagnosis and cachexia history in both groups, while HDL and triglycerides were significant in non-well-controlled smokers only. Our findings that lower BMI at HIV diagnosis, history of cachexia among individuals with well-controlled HIV, and cachexia presence at diagnosis are associated with increased risk of developing NSCLC in PWH with a history of smoking have important implications.
KW - AIDS
KW - Antiretroviral therapy
KW - Cachexia
KW - Lung cancer
KW - Statins
UR - http://www.scopus.com/inward/record.url?scp=85098274934&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85098274934&partnerID=8YFLogxK
U2 - 10.3390/cancers12123809
DO - 10.3390/cancers12123809
M3 - Article
C2 - 33348663
AN - SCOPUS:85098274934
SN - 2072-6694
VL - 12
SP - 1
EP - 15
JO - Cancers
JF - Cancers
IS - 12
M1 - 3809
ER -