Brain Tumor Res Treat.  2016 Oct;4(2):77-86. 10.14791/btrt.2016.4.2.77.

Impact of Human Immunodeficiency Virus in the Pathogenesis and Outcome of Patients with Glioblastoma Multiforme

• Choy W
• Lagman C
• Lee SJ
• Bui TT
• Safaee M
• Yang I

• KMID: 2356974
• DOI: http://doi.org/10.14791/btrt.2016.4.2.77

Abstract

BACKGROUND
Improvement in antiviral therapies have been accompanied by an increased frequency of non-Acquired Immune Deficiency Syndrome (AIDS) defining malignancies, such as glioblastoma multiforme. Here, we investigated all reported cases of human immunodeficiency virus (HIV)-positive patients with glioblastoma and evaluated their clinical outcomes. A comprehensive review of the molecular pathogenetic mechanisms underlying glioblastoma development in the setting of HIV/AIDS is provided.
METHODS
We performed a PubMed search using keywords "HIV glioma" AND "glioblastoma," and "AIDS glioma" AND "glioblastoma." Case reports and series describing HIV-positive patients with glioblastoma (histologically-proven World Health Organization grade IV astrocytoma) and reporting on HAART treatment status, clinical follow-up, and overall survival (OS), were included for the purposes of quantitative synthesis. Patients without clinical follow-up data or OS were excluded. Remaining articles were assessed for data extraction eligibility.
RESULTS
A total of 17 patients met our inclusion criteria. Of these patients, 14 (82.4%) were male and 3 (17.6%) were female, with a mean age of 39.5±9.2 years (range 19-60 years). Average CD4 count at diagnosis of glioblastoma was 358.9±193.4 cells/mm3. Tumor progression rather than AIDS-associated complications dictated patient survival. There was a trend towards increased median survival with HAART treatment (12.0 vs 7.5 months, p=0.10)
CONCLUSION
Our data suggests that HAART is associated with improved survival in patients with HIV-associated glioblastoma, although the precise mechanisms underlying this improvement remain unclear.

Keyword

Acquired Immune Deficiency Syndrome; Antiretroviral therapy, highly active; Glioblastoma; HIV

MeSH Terms

Acquired Immunodeficiency Syndrome
Antiretroviral Therapy, Highly Active
CD4 Lymphocyte Count
Diagnosis
Female
Follow-Up Studies
Glioblastoma*
HIV*
Humans*
Male
World Health Organization

Figure

• 

  Fig. 1 The effect of HAART on survival among HIV-positive patients with glioblastoma. Among patients receiving HAART, survival was 16.7±8.1 months (n=3) compared to 5.8±4.8 months (n=14) in patients who did not receive HAART (p=0.0063). HAART, highly active antiretroviral therapy; HIV, human immunodeficiency virus.

• 

  Fig. 2 Kaplan-Meier survival among HIV-positive patients with diagnosis of glioblastoma. HAART use (dotted line) demonstrated a trend towards increased median survival with HAART treatment (12.0 vs 7.5 months, p=0.10) HAART, highly active antiretroviral therapy; HIV, human immunodeficiency virus.

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