Profile of Patients with Digestive Tube Cancer Infected With HIV in Two Cancerology Centers in Cameroon

Abstract

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) Conclusion: 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.