Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Feb;85(2):415-21.
doi: 10.1016/j.urology.2014.09.054. Epub 2014 Nov 4.

Clinical presentation and outcomes of prostate cancer in an urban cohort of predominantly African American, human immunodeficiency virus-infected patients

David J Riedel  1 , Eric R Cox  2 , Kristen A Stafford  3 , Bruce L Gilliam  4
Affiliations

Clinical presentation and outcomes of prostate cancer in an urban cohort of predominantly African American, human immunodeficiency virus-infected patients

David J Riedel et al. Urology. 2015 Feb.

Abstract

Objective: To determine the clinical presentation and outcomes of prostate cancer in human immunodeficiency virus (HIV)-infected men compared with HIV-uninfected men in an urban setting.

Methods: A retrospective cohort study of prostate cancer stage at diagnosis and mortality comparing HIV-infected patients with HIV-uninfected patients from 2000 to 2011 was carried out. Clinical features, HIV history, cancer presentation, and outcomes were reviewed. Cox proportional hazards analysis was performed to estimate the association between HIV status and mortality.

Results: A total of 54 HIV-infected subjects were identified and reviewed, and 49 of them had complete data available; they were compared with 1496 HIV-uninfected subjects with prostate cancer. HIV-infected subjects were younger (median age, 60.7 vs 64 years) and had a higher proportion of African Americans (92% vs. 45%). An elevated prostate-specific antigen (PSA) level (76%) was the predominant indication for biopsy; 10 patients (27%) with an elevated PSA level had normal findings on digital rectal examination. Eighteen men (37%) presented with stage III and IV disease compared with 14% in the general population (P <.001). Eight patients (16%) died of prostate cancer. Subjects with HIV progressed to death at a significantly faster rate than those in the general population (adjusted hazard ratio, 2.02; 95% confidence interval, 1.14-3.58).

Conclusion: HIV-infected patients in this cohort presented with more advanced stage disease compared with the general population even though the majority were detected by screening PSA. The overall mortality rate was higher for HIV-infected patients with prostate cancer after controlling for race, tumor stage at diagnosis, and age. Prostate cancer screening methods may need to be individualized for HIV-infected men.

PubMed Disclaimer

Conflict of interest statement

All others declare no conflicts of interest.

Figures

Figure 1
Figure 1
A Kaplan Meier plot, stratified by stage at diagnosis (III and IV vs. I and II) (p = 0.03); Figure 1B Kaplan Meier plot, stratified by indication for prostate biopsy (elevated PSA vs. abnormal DRE) (p = 0.76); Figure 1C Kaplan Meier plot, stratified by HIV-uninfected (Group 1) vs. HIV-infected (Group 2) (p=0.006).
Figure 1
Figure 1
A Kaplan Meier plot, stratified by stage at diagnosis (III and IV vs. I and II) (p = 0.03); Figure 1B Kaplan Meier plot, stratified by indication for prostate biopsy (elevated PSA vs. abnormal DRE) (p = 0.76); Figure 1C Kaplan Meier plot, stratified by HIV-uninfected (Group 1) vs. HIV-infected (Group 2) (p=0.006).
Figure 1
Figure 1
A Kaplan Meier plot, stratified by stage at diagnosis (III and IV vs. I and II) (p = 0.03); Figure 1B Kaplan Meier plot, stratified by indication for prostate biopsy (elevated PSA vs. abnormal DRE) (p = 0.76); Figure 1C Kaplan Meier plot, stratified by HIV-uninfected (Group 1) vs. HIV-infected (Group 2) (p=0.006).
See this image and copyright information in PMC

Comment in

  • Editorial comment.
    Levinson AW. Levinson AW. Urology. 2015 Feb;85(2):421-2. doi: 10.1016/j.urology.2014.09.057. Urology. 2015. PMID: 25623707 No abstract available.
  • Reply: To PMID 25623706.
    Riedel DJ, Gilliam BL, Cox ER, Stafford KA. Riedel DJ, et al. Urology. 2015 Feb;85(2):422. doi: 10.1016/j.urology.2014.09.058. Urology. 2015. PMID: 25623708 No abstract available.

References

    1. Patel P, Hanson DL, Sullivan PS, Novak RM, Moorman AC, Tong TC, Holmberg SD, Brooks JT. Incidence of types of cancer among HIV-infected persons compared with the general population in the United States, 1992–2003. Ann Intern Med. 2008;148:728–736. - PubMed
    1. Silverberg MJ, Chao C, Leyden WA, Xu L, Tang B, Horberg MA, Klein D, Quesenberry CP, Jr, Towner WJ, Abrams DI. HIV infection and the risk of cancers with and without a known infectious cause. AIDS. 2009;23:2337–2345. - PMC - PubMed
    1. Bedimo RJ, McGinnis KA, Dunlap M, Rodriguez-Barradas MC, Justice AC. Incidence of non-AIDS-defining malignancies in HIV-infected versus noninfected patients in the HAART era: impact of immunosuppression. J Acquir Immune Defic Syndr. 2009;52:203–208. - PMC - PubMed
    1. Marcus JL, Chao CR, Leyden WA, Xu L, Klein DB, Horberg MA, Towner WJ, Quesenberry CP, Jr, Abrams DI, Van Den Eeden SK, et al. Prostate Cancer Incidence and Prostate-Specific Antigen Testing Among HIV-Positive and HIV-Negative Men. J Acquir Immune Defic Syndr. 2014;66:495–502. - PubMed
    1. Crum NF, Spencer CR, Amling CL. Prostate carcinoma among men with human immunodeficiency virus infection. Cancer. 2004;101:294–299. - PubMed

Publication types