Characterizing Prostate Cancer in Patients With HIV or AIDS

By Patrick Daly - Last Updated: November 30, 2022

As treatments for HIV infection have evolved, the overall HIV population has expanded to included older patients, and studies have started to examine non-AIDS-defining cancers in people living with HIV/AIDS (PLWHA), according to a presentation by Tina Vaziri at the 23rd Annual Meeting of the Society of Urologic Oncology.

In a retrospective analysis, Vaziri and colleagues examined characteristics and outcomes of PLWHA with prostate cancer and reported the following:

Radical prostatectomy (RP) and radiation therapy (RT) with or without androgen deprivation therapy (ADT) was an effective treatment strategy
Cryosurgery (CS) was associated with worse progression-free survival (PFS) compared with other treatments used in the same risk group
CD4 cell counts declined in patients treated with RT (P=.018), which the authors noted warrants further investigation

The study included 79 patients from a single institution who were positive for HIV and had biopsy-diagnosed prostate cancer with elevated prostate-specific antigen (PSA) levels. Patients had a median age of 61 years at the time of prostate cancer diagnosis after a median HIV infection duration of 21 years. This was, to the authors’ knowledge, the largest published cohort on this population.

Scientists Characterize Features and Outcomes of PCa in PLWHA

At diagnosis, median PSA was 6.85 ng/mL, and median Gleason score was 7. Among the cohort, 34.2% received RT with or without ADT, 30.4% received RP, 13.9% received RP plus RT, 12.7% received CS, and 8.9% elected for active surveillance.

Over a median follow-up of 4 years, the overall rate of 5-year PFS was 82.5%, with the poorest survival rates reported in the RP plus RT (54%) and CS (70%) groups. The 5-year overall survival was 97.5%, and the authors found no recorded prostate cancer-specific deaths.

The evidence supported the use of current standard-of-care treatment strategies and opposed the use of CS in patients with HIV or AIDS and prostate cancer, the authors concluded.