Quantifying the Relationship of HIV Infection with Clinicopathological Spectrum and Outcome Among Patients with Colorectal Cancer in a South African Population

Overview

Journal Afr Health Sci

Date 2022 Nov 21

PMID 36407346

Authors

S K Pillay

Z Moolla

Y Moodley

T E Madiba

Affiliations

Soon will be listed here.

Abstract

Introduction: Literature is limited on HIV and colorectal cancer (CRC) in sub-Saharan Africa despite it being the epicentre of the HIV epidemic.

Purpose: To compare clinicopathological features and outcome of CRC in HIV-negative and HIV-positive patients.

Methods: Retrospective analysis of a prospective CRC database. Demographic details, HIV status, anatomical site, disease stage, treatment and follow-up were documented.

Results: Of 715 patients with CRC, 145 and 570 tested positive and negative respectively for HIV. Median age was 45 (IQR 36-53 and 57 (IQR 45-66) years among HIV-positive and HIV-negative patients respectively (p<0.0001). Tumour differentiation differed between the two groups (p=0.003) but staging was not different (p=0.6). Surgical resection rate was 52% for HIV-positive patients versus 59% for HIV-negative patients (p=0.07). Median follow-up was 9 (IQR 2-20.5) months for HIV-positive patients and 12 (IQR 6-29) months for HIV-negative patients (p=0.154). Recurrence rate was 14.7% among HIV positive patients and 6.8% in HIV negative patients (p=0.089).

Conclusion: When compared with HIV-negative patients, HIV-positive patients with CRC presented at a younger age and tended to have lower surgical resection rates. There was no difference between the two groups with CRC in terms of anatomical sub-site distribution, disease staging and recurrence rates.

Citing Articles

Patients with colorectal cancer combined with HIV had a worse overall survival after surgery: a meta-analysis.

Yang W, Zhou X, He G Front Oncol. 2025; 15:1440105.

PMID: 39944832 PMC: 11813759. DOI: 10.3389/fonc.2025.1440105.

Unraveling the Complex Interconnection between Specific Inflammatory Signaling Pathways and Mechanisms Involved in HIV-Associated Colorectal Oncogenesis.

Damane B, Mulaudzi T, Kader S, Naidoo P, Savkovic S, Dlamini Z Cancers (Basel). 2023; 15(3).

PMID: 36765706 PMC: 9913377. DOI: 10.3390/cancers15030748.

Editorial.

Tumwine J Afr Health Sci. 2022; 22(2):i-vi.

PMID: 36407340 PMC: 9652691. DOI: 10.4314/ahs.v22i2.1.

References

Coghill A, Shiels M, Suneja G, Engels E . Elevated Cancer-Specific Mortality Among HIV-Infected Patients in the United States. J Clin Oncol. 2015; 33(21):2376-83. PMC: 4500831. DOI: 10.1200/JCO.2014.59.5967. View

Rajasuriar R, Chong M, Ahmad Bashah N, Abdul Aziz S, McStea M, Lee E . Major health impact of accelerated aging in young HIV-infected individuals on antiretroviral therapy. AIDS. 2017; 31(10):1393-1403. DOI: 10.1097/QAD.0000000000001475. View

Rowe K, Moodley K . Patients as consumers of health care in South Africa: the ethical and legal implications. BMC Med Ethics. 2013; 14:15. PMC: 3614872. DOI: 10.1186/1472-6939-14-15. View

Meir-Shafrir K, Pollack S . Accelerated Aging in HIV Patients. Rambam Maimonides Med J. 2013; 3(4):e0025. PMC: 3678823. DOI: 10.5041/RMMJ.10089. View

Deeken J, Tjen-A-Looi A, Rudek M, Okuliar C, Young M, Little R . The rising challenge of non-AIDS-defining cancers in HIV-infected patients. Clin Infect Dis. 2012; 55(9):1228-35. PMC: 3529613. DOI: 10.1093/cid/cis613. View

. Population policy in South Africa. Stud Fam Plann. 1993; 24(1):31-9. View

Higgins J, Hoffman S, Dworkin S . Rethinking gender, heterosexual men, and women's vulnerability to HIV/AIDS. Am J Public Health. 2010; 100(3):435-45. PMC: 2820057. DOI: 10.2105/AJPH.2009.159723. View

Becker J, Tsague L, Sahabo R, Twyman P . Provider Initiated Testing and Counseling (PITC) for HIV in resource-limited clinical settings: important questions unanswered. Pan Afr Med J. 2011; 3:4. PMC: 2984289. DOI: 10.4314/pamj.v3i1.52442. View

Wasserberg N, Nunoo-Mensah J, Gonzalez-Ruiz C, Beart Jr R, Kaiser A . Colorectal cancer in HIV-infected patients: a case control study. Int J Colorectal Dis. 2007; 22(10):1217-21. DOI: 10.1007/s00384-007-0285-z. View

10.

Berretta M, Di Benedetto F, Bearz A, Simonelli C, Martellotta F, Del Ben C . FOLFOX-4 regimen with concomitant highly active antiretroviral therapy in metastatic colorectal cancer HIV-infected patients: a report of five cases and review of the literature. Cancer Invest. 2008; 26(6):610-4. DOI: 10.1080/07357900701781747. View

11.

Chu K, Tarone R, Chow W, Alexander G . Colorectal cancer trends by race and anatomic subsites, 1975 to 1991. Arch Fam Med. 1995; 4(10):849-56. DOI: 10.1001/archfami.4.10.849. View

12.

WALKER A, Segal I . Colorectal cancer in an African city population in transition. Eur J Cancer Prev. 2002; 11(2):187-91. DOI: 10.1097/00008469-200204000-00012. View

13.

Wang C, Silverberg M, Abrams D . Non-AIDS-Defining Malignancies in the HIV-Infected Population. Curr Infect Dis Rep. 2014; 16(6):406. PMC: 4085772. DOI: 10.1007/s11908-014-0406-0. View

14.

Shiels M, Althoff K, Pfeiffer R, Achenbach C, Abraham A, Castilho J . HIV Infection, Immunosuppression, and Age at Diagnosis of Non-AIDS-Defining Cancers. Clin Infect Dis. 2016; 64(4):468-475. PMC: 5850313. DOI: 10.1093/cid/ciw764. View

15.

Mabaso M, Makola L, Naidoo I, Mlangeni L, Jooste S, Simbayi L . HIV prevalence in South Africa through gender and racial lenses: results from the 2012 population-based national household survey. Int J Equity Health. 2019; 18(1):167. PMC: 6821038. DOI: 10.1186/s12939-019-1055-6. View

16.

Sigel C, Cavalcanti M, Daniel T, Vakiani E, Shia J, Sigel K . Clinicopathologic Features of Colorectal Carcinoma in HIV-Positive Patients. Cancer Epidemiol Biomarkers Prev. 2016; 25(7):1098-104. PMC: 4942127. DOI: 10.1158/1055-9965.EPI-15-1179. View

17.

Cappell M . Pathophysiology, clinical presentation, and management of colon cancer. Gastroenterol Clin North Am. 2008; 37(1):1-24, v. DOI: 10.1016/j.gtc.2007.12.002. View

18.

Coovadia H, Jewkes R, Barron P, Sanders D, McIntyre D . The health and health system of South Africa: historical roots of current public health challenges. Lancet. 2009; 374(9692):817-34. DOI: 10.1016/S0140-6736(09)60951-X. View

19.

Myer L, Ehrlich R, Susser E . Social epidemiology in South Africa. Epidemiol Rev. 2004; 26:112-23. DOI: 10.1093/epirev/mxh004. View

20.

Kan M, Wong P, Press N, Wiseman S . Colorectal and anal cancer in HIV/AIDS patients: a comprehensive review. Expert Rev Anticancer Ther. 2014; 14(4):395-405. DOI: 10.1586/14737140.2013.877843. View