Pancreatic cancer in people with HIV: a case-control study.

Abstract

Background: We aimed to estimate the incidence and to assess the risks factors associated with pancreatic cancer (PC) in people with HIV (PWH).

Setting: We used electronic medical record data from 2009 to 2020 available in the COREVIH Ile-de-France Est database of PWH treated in Paris' public hospitals.

Methods: We analyzed data on patient demographics, treatment history, and immuno-virologic status. A case-control study was designed, each case (PWH and PC) was matched on age, gender and duration of HIV infection to four controls (PWH without PC).

Results: Twenty-four cases were identified from the database, with an incidence of PC estimated at 28 cases (95%CI [19-43]) per 100,000 persons-year. The median age was 57 years (IQR [51-68]) at cancer diagnosis. Twenty-one cases were male (88%). Median CD4+ T cell count at PC diagnosis was 587/mm3 (IQR [317-748]) and the nadir CD4+ T cell count was 194 (IQR [98-380]). Twenty cases (91%) had a suppressed HIV replication at PC diagnosis. Twelve patients (50%) had metastasis on diagnosis. Median time to death after cancer diagnosis was 11 months [IQR 1-19]. Twenty-two cases were matched with 88 controls. There was no statistically significant risk factors for PC identified in our analysis.

Conclusion: Pancreatic cancer remains rare in PWH and is associated with a severe prognosis at a relatively young age. Further studies are needed to identify risk factors associated with pancreatic cancer development in people with HIV.