HIV And Esophageal Cancer In Mozambique: What Can We Learn?
Abstract
Esophageal cancer (EC) is a common cancer in Mozambique, with esophageal squamous cell carcinomas (ESCC) being the most frequent subtype of this cancer. Little is known about the impact of the human immunodeficiency virus (HIV) on this pathology. The main goal of this study was to assess the association between EC and HIV infection.
Methods: A case-control study was conducted, in 2018, at Maputo Central Hospital, Mozambique (MCH). Consenting adults were eligible for inclusion. Patients with ESCC who underwent HIV testing constituted the case groups. Controls were selected from patients with surgical benign conditions, and they were matched by sex and age. Chi-square or Fisher’s exact tests were used to evaluate the association between two categorical variables. Comparisons between groups were performed, using independent samples t-tests or Mann–Whitney tests for continuous variables. Odds Ratio (OR), and the corresponding 95% confidence interval (CI) were computed using non-conditional logistic regression. A p-value < 0.05 was considered significant.
Results: During the study period, 92 cases and 92 controls were enrolled into the study. 67.4% of the cases were female. The median age of cases and controls was 57 (35-83) and 52 (35-85) years, respectively.
HIV-positive diagnosis significantly increased the odds of developing EC, mainly in females (OR=4.81; 95% CI: 2.24–10.32; p<0.001), but the same did not occur in males (OR=2.26; 95% CI: 0.80–6.36; p=0.123).
Conclusion: Esophageal cancer and human immunodeficiency virus are common in Mozambique. HIV infection is a potential risk factor for ESCC mainly in the female gender. Patients with HIV and other risk factors such as exposure to domestic or tobacco smoke should be educated and followed up for an early diagnosis of esophageal cancer.
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