S0097 Is Human Immunodeficiency Virus Associated With Pancreatic Cancer?

Abstract

INTRODUCTION: Pancreatic cancer is the fourth most common cause of cancer-related death in the United States (US). Despite recent advancements, the 5-year survival rate of this highly malignant neoplasm is still 9%. The association of exocrine pancreatic adenocarcinoma (EPA) with infectious etiologies has not been well-explored. In this abstract, we will discuss the association of EPA with HIV in patients with or without AIDS-defining illness. METHODS: We used the 2009 to 2014 nationwide inpatient sample database (NIS) for this study. NIS is the largest publicly available all-payer inpatient database in the US that >7 million hospital stays each year, as a part of the Healthcare Cost and Utilization Project (HCUP). International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9CM) codes for HIV infection (ICD-9 V08, 042 codes) and EPA subtypes (ICD-9 1570, 1571, 1572, 1578, 1579) were obtained. Logistic regression was used to model the association between EPA of the head, body, tail or combined EPA and HIV infection (asymptomatic and with defining illness patients). Participants included in this study were aged 18 years and above. RESULTS: From 2009 to 2014 there were 109,566 patients identified with EPA. The mean age of diagnosis was 67 years. The female to male ratio was 1.46:1 with most of the patients being white (68.5%). Regardless of the specific anatomic site, EPA is significantly lower in patients with asymptomatic HIV infection and HIV defining illness (P < 0.001). Using logistic regression, this negative association is independent of age, sex, race, diabetes, smoking status, obesity, and insurance type (Table 1). When subtypes of EPA based on location were considered, EPA of the head is negatively associated with both asymptomatic HIV infections and HIV defining illnesses, while EPA of the body and tail are not associated with HIV (Table 1). CONCLUSION: Various mechanisms of oncogenic pathogenesis in HIV patients have been proposed, including chronic inflammation and immune system dysregulation. Literature was noted to be sparse in analyzing the relationship between EPA and HIV infection. In this abstract, EPA of the head is less likely in patients with HIV, compared to non-HIV patients. This relationship is unexplained, perhaps due to antiretrovirals use. Further well-designed studies with a good sample size are needed to further explore any existing correlation between these highly malignant diseases.Table 1.: Multivariable analysis of association between HIV infection and pancreatic cancer