Profile of Patients with Digestive Tube Cancer Infected With HIV in Two Cancerology Centers in Cameroon
- HIV; Digestive tract cancer; Prevalence; Prognostic factors
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Background: Human Immunodeficiency Virus (HIV) infection is a major public health problem in Africa, which alone recorded 71% of HIV / AIDS-related deaths in 2018. There is a link between the infection to HIV and the occurrence of certain cancers, in particular digestive cancers. Very little data in Africa, especially Cameroon, exists on the association between HIV and digestive cancers. Our goal was to determine the prevalence of HIV in patients with cancer of the digestive tract as well as the factors related to the prognosis of these patients in Cameroon.
Methods: We conducted a cross-sectional and analytical study over a 10-year period from January 2010 to December 2019. It was carried out in the general hospitals of the cities of Douala and Yaoundé. We included records of patients with histologically confirmed gastrointestinal cancer. We excluded records of patients with lymphoma or Kaposi’s sarcoma. The data collected were socio-demographic, clinical and paraclinical data. Chi-square test was used to determine statistically significant associations for p <0.05.
Results: We collected 294 files, among which 71 had positive HIV serology, either a prevalence of 24.15%. The average age of the patients was 53,7±13,6 years old. The sex ratio was 1.08. The main locations were the colon with 28.7% (N = 20) and the anus with 25.4% (N = 18). At the time of HIV diagnosis, the mean CD4 count at the time of HIV diagnosis was 413,2±189,3/mm3 and the mean viral load was 5129±2786,8copies/mm3. When diagnosed with cancer, the average CD4 count was 287,84±101,7/mm3 and the average viral load was 25385,5±19784,3/mm3. The anal location (p = 0.003), the necrotic appearance (p = 0.001), the poorly differentiated character (p = 0.02) of the tumors and the death of the patients (p = 0.000) were statistically linked to positive HIV serology. Factors associated with the prognosis of HIV positive patients were CD4 count <200 / mm3 (p = 0.002) and the existence of metastases (p = 0.04)
The prevalence of HIV in patients with cancer of the digestive tract is 24.15%. The anal location, the necrotic appearance and the undifferentiated nature of the tumors are related to positive HIV serology. Prognostic factors are a CD4 count <200 / mm3 and the existence of metastases.
- UNAIDS data 2019. Global HIV and AIDS statis-tics. 25th December 2018
- UNAIDS. Country factsheets Cameroon 2018.pdf [Internet]. Available from:. https://www.unaids.org/sites/default/files/media_asset/global-aids-monitoring_en.pdf
- HIV Infection and Cancer Risk [Internet]. National Cancer Institute. 2017 [cited Nov 2019]. Available from: https://www.cancer.gov/about-cancer/caus-es-prevention/risk/infectious-agents/hiv-fact-sheet
- Thrift AP, Chiao EY et al. Are Non-HIV Malignan-cies Increased in the HIV-Infected Population? Curr Infect Dis Rep. 2018 Aug;20(8):22.
- Clifford GM, Polesel J, et al. Cancer Risk in the Swiss HIV Cohort Study: Associations With Im-munodeficiency, Smoking, and Highly Active Antiretroviral Therapy. JNCI Journal of the Na-tional Cancer Institute. 2005 Mar 16;97(6): 425–32.
- Nagata N, Nishijima T, et al. Increased risk of non-AIDS-defining cancers in Asian HIV-infected patients: a long-term cohort study. BMC Cancer. 2018 Dec;18(1):1066.
- Deeken J.F, Tjen-A-Looi A et al. The Rising of Non AIDS-Defining Cancers in HIV infected Pa-tients. Clin Infect Dis. 2012 Nov;55(9):1228-35.
- Ebogo-Belobo J-T, Kagoué Simeni L-A, et al. In-cidence of cancer in people living with HIV and prognostic value of current CD4. Bull Cancer. 2019 Mar;106(3):201–5.
- Enow Orock G et al. Co-morbidity of HIV and Cervical Cancer: A One Year Multicentric Pilot Study in Cameroon. 2019;6.
- Enow Orock et al. Co Morbidity of HIV and Breast Cancer: A One Year Multicentric Pilot Study in Cameroon. (194):6.
- WT Bekolo, Eloumou SAFB et al. Facteurs pro-nostiques du cancer de l’œsophage au Came-roun: étude multicentrique. Pan Afr Med Journal. 2019; 33:73.
- SAF Eloumou Bagnaka, WT Bekolo Nga et al. Facteurs pronostiques du Cancer colorectal au Cameroun. Health Sciences and Diseases. 2020 ; 20 (2).
- Ouedraogo S, Ouedraogo S, Kambire JL, Zoungrana SL, et al. [Epidemiological, clinical, histological, and therapeutic features of primary digestive cancers in Burkina Faso]. Bull Cancer. 2018 Dec;105(12):1119–25.
- Ouedraogo S, Ouedraogo S, Kambire JL, Zoun- grana SL, et al. [Epidemiological, clinical, histolo- gical, and therapeutic features of primary diges- tive cancers in Burkina Faso]. Bull Cancer. 2018 Dec;105(12):1119–25.
- Lu R, Wu S, et al. HIV Infection Accelerates Gastrointestinal Tumor Outgrowth in NSG-HuPBL Mice. AIDS Research and Human Retroviruses. 2014 Jul;30(7):677–84.
- Bray F, Ferlay J, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 coun-tries. CA Cancer J Clin. 2018;68(6):394–424.
- Ouedraogo S., Ouedraogo S. et al. Profil épi-démi- ologique, clinique, histologique, et théra-peutique des cancers digestifs primitifs dans les régions du nord et est du Burkina Faso. Bulletin du Cancer. 2018 ; 105(12) : 1119-1125.
- Kissi Azouan-Kacou H. Y., Doffou S.A et al. Prise en charge des cancers digestifs en Côte d’Ivoire : expérience du service d’Hépato-gastroentéro- logie du CHU de Youpougon. Journal africain d’Hépato-gastroentérologie. 2017 ;11 :13-18.