1617P - Prevalence and impact of HIV infection on mortality rate and overall survival of cancer patients in a Haitian cancer clinic

Background

The prevalence of HIV infection in Haiti is around 2%. HIV-positive patients are more likely to develop neoplasms than HIV-negative individuals and have a poorer outcome. This study aimed to estimate the prevalence of HIV infection among cancer patients and to evaluate the impact of HIV infection on mortality and overall survival.

Methods

A four-year retrospective study was conducted in the cancer program of Innovating Health International (IHI). We included all cancer patients with a known HIV status enrolled from January 1^st, 2016 to December 31^st, 2019. We sought to evaluate if HIV infection was associated with mortality rate and survival in our setting.

Results

Of the 2300 cancer patients, 1062 (46.2%) had a known HIV status. Eighty-three (7.8%) were HIV-positive, among them 63 women and 20 men. Their mean age was 47.2 years versus 51.1 years for the HIV-negative patients (p = 0.01). Thirty-five (35) patients had AIDS-defining cancers (ADC) such as invasive cervical cancer (n=27), non-Hodgkin lymphoma (n=7) and Kaposi’s sarcoma (n=1). Forty-four (44) patients had Non-AIDS-defining cancers (NADC) such as breast cancer (n=15), head and neck cancers (n=11), gastrointestinal cancers (n=3), penile cancer (n=3), Hodgkin’s lymphoma (n=2), lung cancer (n=2), ovarian cancer (n=2), sarcomas (n=2), skin cancer from degenerated giant condyloma (n=2) and vulvar cancer (n=2). Four (4) patients had a cancer of unknown primary (CUP). 78.3% of the patients were known HIV-positive before cancer care and on antiretroviral therapy. HIV-positive cancer patients were more likely to have stage IV disease (Odds ratio (OR)= 1.39 [95% CI, 0.87 – 2.24], p = 0.17) or die (OR= 1.76 [95% CI, 1.09 – 2.83], p=0.02) than HIV-negative ones. The overall mortality rate was 44.6% versus 34.5% for the HIV-negative patients (p=0.03). The overall survival was 13.3 months versus 45.2 months for HIV-negative ones (p < 0.001).

Conclusions

The prevalence of HIV infection among cancer patients was 7.8% [95% CI, 6.3% - 9.6%], with a predominance of Non-AIDS-defining malignancies. The HIV-positive patients were significantly younger and more likely to have metastatic cancer. HIV infection was associated with increased mortality rate and reduced overall survival.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.