Bladder cancer in patients with HIV infection: a retrospective study of 14 cases

Abstract Purpose: This study was intended to determine whether differences existed between bladder cancers in HIV-infected patients compared to those in the general population. Patients and methods: In this study, 14 patients with HIV infection were found also to have bladder cancer, treated in Beijing Ditan Hospital and Beijing You 'an Hospital from 2013 to 2021. The retrospective study parameters analyzed included HIV infection route, regular treatment, viral load and number of CD4+T lymphocytes prior to surgery, and preoperative laboratory examination. Details specific to bladder cancer included pathological stage and grade, treatment, recurrence at 3 months and longer-term follow-up. Results: The study comprised 13 males (93%) and 1 female (7%), with a median age of 50.5 years, of whom only 9 patients received regular antiretroviral therapy after HIV infection. The median value of CD4+T lymphocytes detected before surgery was 368 cells/μL (range: 147cells/μL-759cells /μL). Other preoperative laboratory results were as follows (median counts): WBC, 6.165×109 /L; erythrocytes, 4.16×1012 /L; hemoglobin, 214.5 g/L; platelets, 143×109 /L; creatinine, 70.85μmol/L; and serum albumin, 41.5 g/L. All patients were treated surgically, 11 of whom had non-muscle invading bladder cancer that underwent localized tumor resection (plus epirubicin bladder infusion) , and the remaining 3 patients had tumor invasion of the muscle that required radical resection (plus postoperative chemotherapy). The cancers were all urothelial, 5 high-grade and 9 low-grade histologically. At three months postoperatively, 3 cases had recurred and were re-excised, 7 had no evidence of recurrence, and 4 had not undergone reevaluation. On subsequent longer-term follow-up (median, 40 months), 2 patients had died[1] of unrelated causes, 10 were alive[2] including 1 with liver metastasis, and 2 were lost to follow-up.Conclusions: The clinical characteristics of HIV-positive patients with bladder cancer were similar to those of the general population with the exception of a significant earlier onset of disease. The type and stages of the bladder cancer, treatment, and outcomes of these patients were also similar to the general population. However, the cause of earlier onset of bladder cancer in HIV positive patients remains to be further elucidated.