326 Background: Advances in highly active antiretroviral therapy (HAART) have markedly improved the life expectancy of people living with HIV (PLWH). As this population ages, prostate cancer (PCa) is expected to become one of the most common malignancies. Although studies show a lower incidence of PCa in PLWH, early evidence suggests more advanced disease at presentation and higher mortality. This study characterizes the demographics and survival outcomes of PLWH diagnosed with PCa. Methods: A retrospective cohort study using the TriNetX US Collaborative Network, comprising de-identified EHR data from over 131 million patients. Men aged 18 to 90 with PCa were stratified by HIV status. Those with another malignancy within one year, excluding non-melanoma skin cancer, were excluded. Demographics, treatments, and outcomes were analyzed using 1:1 propensity score matching, Chi-square tests, Kaplan-Meier survival, and Cox proportional hazards models. Results: Among 625,752 patients included in the study, 1,645 were PLWH. Compared with the cohort without HIV, PLWH diagnosed with PCa were younger at diagnosis (mean age 62 vs. 67 years), more likely to be Black or Hispanic, and more often received care at hospitals in the Southern United States ( p < 0.001). PLWH with PCa also exhibited higher rates of comorbid conditions, including diabetes, hypertension, and obesity ( p < 0.001). After propensity score matching, 3-year survival was significantly lower among PLWH ( p < 0.05), with a mean follow-up of approximately 4 years in both groups (Table 1). Incomplete pathologic reporting (i.e. <10% in each cohort) limited further characterization of the clinical stage and Gleason grade group. Conclusions: PLWH who develop PCa represent a distinct clinical population characterized by younger age at diagnosis, greater comorbidity burden, and lower post-diagnosis survival compared to patients without HIV. These findings highlight the need for tailored PCa screening, management, and survivorship strategies for PLWH to address disparities in outcomes. Future directions will focus on outcomes after specific treatments such as surgery and radiation in PLWH. Kaplan-Meier survival of patients with prostate cancer (PCa) by HIV status. 1 year 2 years 3 years 4 years PCa + HIV 96.3% 93.3% 91.4%* 89.8%* PCa (- HIV) 96.3% 95.1% 93.9%* 92.2%* Kaplan-Meier estimates of overall survival at 1, 2, 3, and 4 years following diagnosis of PCa, after 1:1 propensity score matching. * p < 0.05
Wardrop et al. (Sun,) studied this question.