Pancreatic cancer in HIV-positive patients: a clinical case-control study

Pancreas. 2012 Nov;41(8):1331-5. doi: 10.1097/MPA.0b013e31824a0e40.

Abstract

Objectives: Pancreatic cancer (PC) is the fourth and fifth most common cause of cancer-related death among men in United States and in Europe, respectively. No data are available for HIV-positive patients. The aim of this study was to investigate and to compare clinical presentation and outcome between HIV-positive and HIV-negative PC patients.

Methods: From April 1988 to June 2010, the Italian Cooperative Group on AIDS and Tumors identified 16 cases of HIV-positive PC patients. Each HIV-positive patient from our institution was randomly matched (ratio 1:2) with HIV-negative patients (32 controls) based on sex and year of PC diagnosis. Differences in clinical presentation, treatment, and overall survival were assessed.

Results: At multivariate analysis, HIV-positive patients compared with HIV-negative patients had a higher risk of an unfavorable performance status (PS ≥ 2) and a younger age (<50 years) at cancer diagnosis. At multivariate analysis, HIV-positive status and PS of 2 or greater were the only 2 features that significantly reduced PC patients' survival.

Conclusions: Our data show, for the first time, that HIV-positive PC patients, compared with HIV-negative patients, are younger at cancer diagnosis. Furthermore, they share a more unfavorable PS and a shorter survival.

MeSH terms

  • Adult
  • Age of Onset
  • Aged
  • Anti-HIV Agents / therapeutic use
  • Antineoplastic Agents / therapeutic use
  • Antiretroviral Therapy, Highly Active / statistics & numerical data
  • Case-Control Studies
  • Comorbidity
  • Female
  • HIV Infections / drug therapy
  • HIV Infections / epidemiology*
  • HIV Infections / mortality
  • Humans
  • Incidence
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Pancreatic Neoplasms / drug therapy
  • Pancreatic Neoplasms / epidemiology*
  • Pancreatic Neoplasms / mortality
  • Retrospective Studies
  • Severity of Illness Index

Substances

  • Anti-HIV Agents
  • Antineoplastic Agents