Association between HIV status and positive prostate biopsy in a study of US veterans

It is estimated that 1.2 million Americans are infected with HIV. With advances in treatment and improved survival, HIV-positive patients are increasingly reaching an age when prostate cancer becomes a health issue. While there have been some reports in the literature reporting lower incidence of prostate cancer in HIV population cohorts, these studies have focused on younger populations, where we expect a lower incidence of prostate cancer. Our study involves patients over a 5.5 year period from a busy referral Veterans Medical Center referred to our urology clinic with either elevated PSA or abnormal DRE. Of these patients referred to our clinic, there is a markedly higher rate of prostate cancer in HIV patients when compared to our HIV-negative or HIV-unknown population. Though one may surmise a referral bias, in our highly regulated system, we use identical referral criterion for both HIV-positive and HIV-negative patients. Though this is a study with admittedly limited numbers, we believe this report is important because it is one of the first studies to address prostate cancer in a older cohort of patients who are referred because of suspicion for prostate cancer.