Staten Island University Hospital Staten Island, NY
Ahmed Elfiky, MD1, Mohammad Abureesh, MD1, Motasem Alkhayyat, MD2, Asmaa Mokhtar, MD1, Hassan Almoussawi, MD1, Jeffrey R. Abergel, MD1; 1Staten Island University Hospital, Staten Island, NY; 2Cleveland Clinic Foundation, Cleveland, OH
Introduction: With advances in highly active antiretroviral therapy (HAART), overall mortality is reduced in human immunodeficiency virus (HIV) positive patients.HIV has been associated with increased risk of acquired immunodeficiency syndrome (AIDS) defining cancers e.g. Kaposi sarcoma and non-Hodgkin'slymphoma and non-AIDS defining cancers e.g. Cervical and lung cancer.Colorectal cancer(CRC) is the third most common cancer diagnosed in both men and women in the United States.There has been limited data looking at CRC in HIV patients. Using a large database, we explored the prevalenceof CRC in patients with HIV. Methods: We queried a commercial database: Explorys Inc, Cleveland, OH, USA; an aggregate of electronic medical records data from 26 major integrated US healthcare systems consisting of 36 hospitals in the US, between the years 2015 and 2020. After we excluded patients with Inflammatory bowel disease, patients with age < 20, and those with family history of gastrointestinal tract malignancies, a cohort of patients with Systematized Nomenclature of Medicine ¬ Clinical Terms (SNOMED–CT) of “Human immunodeficiency virus infection”were identified and prevalence of CRC was calculated. Multivariable model was performed to adjust for cofounding factors. Results: The database comprised 217,570 HIV positiveindividuals.The baseline characteristics of the study population are presented in table 1. Using a univariate analysis, the prevalence of CRCamong HIV positive patients in different age groups are presented in Figure 1. The prevalence of CRC among HIV positive patients was 0.16%, which is two times higher compared to HIV negative patients, 0.08% with statistically significant difference (P < 0.0001).After adjusting for cofounding factors, HIV positive patients were more likely to develop CRCwith OR1.796 (95%CI 1.7-1.8, P < 0.0001) compared to HIV negative individuals(Table 2). Discussion: Our study shows a statistically significant higher prevalence of CRC in HIV positive individuals compared to HIV negative individuals. The study is limited by the fact that we could not identify CD4 count and its relation to the CRC prevalence.HAART has shown todecreaseincidence of AIDS defining cancers but notother cancers. Further prospective studies are needed to shed more light on this association and assess the need for more frequent colorectal cancer screening in HIV positive patients. Meanwhile, physicians should be aware of HIV being potential associationwithcolorectal cancer.
Table 1: Baseline characteristic of study population
the prevalence of CRC among HIV positive patients in different age groups
multivariate analysis with CRC is the outcome
Disclosures: Ahmed Elfiky indicated no relevant financial relationships. Mohammad Abureesh indicated no relevant financial relationships. Motasem Alkhayyat indicated no relevant financial relationships. Asmaa Mokhtar indicated no relevant financial relationships. Hassan Almoussawi indicated no relevant financial relationships. Jeffrey Abergel indicated no relevant financial relationships.