VIH E Cancro Do Esófago Em Moçambique: O Que É Que Aprendemos?
DOI:
https://doi.org/10.34635/rpc.1047Palavras-chave:
cancro do esófago, VIH, MoçambiqueResumo
O cancro do esófago (CE) é um cancro comum em Moçambique, sendo os carcinomas de células escamosas do esófago (CCEE) o subtipo mais frequente deste cancro. Pouco se sabe sobre o impacto do vírus da imunodeficiência humana (VIH) nesta patologia. O principal objetivo deste estudo foi avaliar a associação entre CE e infeção pelo VIH.
Métodos: Um estudo de caso-controlo foi conduzido, em 2018, no Hospital Central de Maputo, Moçambique (HCM). Adultos que consentiram em participar foram considerados elegíveis. Doentes com CCEE que realizaram teste de VIH constituíram o grupo de casos. Os controlos foram selecionados entre os doentes com condições benignas cirúrgicas que seriam operados no HCM, tendo sido emparelhados por sexo e idade. Os testes de qui-quadrado ou exato de Fisher foram utilizados para avaliar potenciais associações entre duas variáveis categóricas. Para realizar comparações entre grupos foi utilizado o teste t para amostras independentes ou o teste de Mann-Whitney para as variáveis contínuas. A razão de chances (OR) e o respetivo intervalo de confiança de 95% (IC) foram calculados usando regressão logística não-condicional. Um valor de p < 0,05 foi considerado significativo.
Resultados: Durante o período de estudo, 92 casos e 92 controlos foram incluídos no estudo. 67,4% dos casos eram do sexo feminino. A idade mediana dos casos e dos controlos foi de 57 (35-83) e 52 (35-85) anos, respetivamente. O diagnóstico de VIH positivo aumentou significativamente as chances de desenvolver CE, principalmente nas mulheres (OR=4,81; IC 95%: 2,24–10,32; p<0,001), mas o mesmo não ocorreu nos homens (OR=2,26; IC 95%: 0,80–6,36; p=0,123).
Conclusão: O cancro do esófago e o vírus da imunodeficiência humana são comuns em Moçambique. A infeção por VIH é um potencial fator de risco para CCEE, principalmente no sexo feminino. Pacientes com VIH e outros fatores de risco, como a exposição ao fumo doméstico ou do tabaco, devem ser educados e acompanhados para um diagnóstico precoce do cancro do esófago.
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Referências
1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68:394–424
2. Uhlenhopp DJ, Then EO, Sunkara T, Gaduputi V. Epidemiology of esophageal cancer: update in global trends, etiology and risk factors. Clin J Gastroenterol. 2020 Dec;13(6):1010-1021. doi: 10.1007/s12328-020-01237-x.)
3. Cheng ML, Zhang L, Borok M, Chokunonga E, Dzamamala C, Korir A, Wabinga HR, Hiatt RA, Parkin DM, Van Loon K. The incidence of oesophageal cancer in Eastern Africa: identification of a new geographic hot spot?. Cancer Epidemiol. 2015;39(2):143-9;
4. Ferlay J, Ervik M, Lam F, et al. Global cancer observatory: cancer today. International Agency for Research on Cancer, Lyon, France. Available from: https://gco.iarc.fr/today. Accessed 08 August 2022.
5. Global Burden of Disease Cancer Collaboration. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: a systematic analysis for the global burden of disease study. JAMA Oncol. 2017;3:524–48.
6. Lorenzoni C, Vilajeliu A, Carrilho C, et al: Trends in cancer incidence in Maputo, Mozambique,1991-2008. PLoS One 2015; 10: e0130469. DOI: 10.1371/journal.pone.0130469
7. Mbulaiteye SM, Katabira ET, Wabinga H, Parkin DM, Virgo P, Ochai R, et al. Spectrum of cancers among HIV-infected persons in Africa: the Uganda AIDS-Cancer Registry Match Study. Int J Cancer. 2006; 118:985–90. [PubMed: 16106415];
8. Loots, E., Sartorius, B., Madiba, T. E., Mulder, C. J. J. & Clarke, D. L. 2017. Oesophageal squamous cell cancer in a South African tertiary hospital: a risk factor and presentation analysis. South African Journal of Surgery 55(3): 42–46
9. Kayamba, V., Bateman, A. C., Asombang, A. W., Shibemba, A., Zyambo, K., Banda, T., Soko, R. & Kelly, P. 2015. HIV infection and domestic smoke exposure, but not human papillomavirus, are risk factors for esophageal squamous cell carcinoma in Zambia: A case-control study. Cancer Medicine 4(4): 588–595,
10. Jensen BE, Oette M, Haes J, Häussinger D. HIV-Associated Gastrointestinal Cancer. Oncol Res Treat. 2017;40(3):115-118. doi: 10.1159/000456714
11. Nutor JJ, Duodu PA, Agbadi P, Duah HO, Oladimeji KE, Gondwe KW. Predictors of high HIV+ prevalence in Mozambique: A complex samples logistic regression modeling and spatial mapping approaches. PLoS One. 2020 Jun 4;15(6):e0234034. doi: 10.1371/journal.pone.0234034. Erratum in: PLoS One. 2020 Jun 25;15(6):e0235456. PMID: 32497145; PMCID: PMC7272061.
12. Come J, Castro C, Morais A, Cossa M, Modcoicar P, Tulsidâs S, Cunha L, Lobo V, Morais AG, Cotton S, Lunet N, Carrilho C, Santos LL. Clinical and Pathologic Profiles of Esophageal Cancer in Mozambique: A Study of Consecutive Patients Admitted to Maputo Central Hospital. J Glob Oncol. 2018 Nov;4:1-9. doi: 10.1200/JGO.18.00147.
13. Cunha Lina, Fontes Filipa, Come Jotamo, Lobo Vitória, Santos Lúcio Lara, Lunet Nuno, Carrilho Carla (2022) Risk factors for oesophageal squamous cell carcinoma in Mozambique ecancer 16 1437
14. Thrift AP, Kramer JR, Hartman CM, Royse K, Richardson P, Dong Y, Raychaudhury S, Desiderio R, Sanchez D, Anandasabapathy S, White DL, Chiao EY. Risk and Predictors of Esophageal and Stomach Cancers in HIV-Infected Veterans: A Matched Cohort Study. J Acquir Immune Defic Syndr. 2019 Jul 1;81(3):e65-e72. doi: 10.1097/QAI.0000000000002038.).
15. Ranjit S, Kumar S. Recent advances in cancer outcomes in HIV-positive smokers. F1000Res. 2018;7:F1000 Faculty Rev-718. Published 2018 Jun 11. doi:10.12688/f1000research.12068.1
16. McCormack VA, Menya D, Munishi MO, et al.: Informing etiologic research priorities for squamous cell esophageal cancer in Africa: A review of setting-specific exposures to known and putative risk factors. Int J Cancer. 2017;140(2):259–71. 10.1002/ijc.30292
17. Moses A, Mwafongo A, Chikasema M, et al.: Risk factors for common cancers among patients at Kamuzu Central Hospital in Lilongwe, Malawi: A retrospective cohort study. Malawi Med J. 2017;29(2):136–41.).
18. Helleberg M, Gerstoft J, Afzal S, et al.: Risk of cancer among HIV-infected individuals compared to the background population: impact of smoking and HIV. AIDS. 2014;28(10):1499–508
19. Park LS, Tate JP, Sigel K, et al.: Time trends in cancer incidence in persons living with HIV/AIDS in the antiretroviral therapy era: 1997-2012. AIDS. 2016;30(11):1795–806. 10.1097/QAD.0000000000001112
20. Ana Catarina Luz , Sophia Baumert , Janet Fisher , Isla Grundy , Maria Matediane , Genevieve Patenaude , Natasha Ribeiro, Casey Ryan , Frank Vollmer , Emily Woollen1 , Pedro Zorrilla Charcoal production and trade in southern Mozambique: historical trends and present scenarios XIV WORLD FORESTRY CONGRESS, Durban, South Africa, 7-11 September 2015, DOI: 10.13140/RG.2.1.1677.8729
21. Nutor JJ, Duodu PA, Agbadi P, Duah HO, Oladimeji KE, Gondwe KW (2020) Predictors of high HIV+ prevalence in Mozambique: A complex samples logistic regression modeling and spatial mapping approaches. PLoS ONE 15(6): e0234034. https://doi.org/10.1371/journal.pone.0234034.
22. Wiginton JM, Mathur S, Gottert A, Pilgrim N, Pulerwitz J. Hearing From Men Living With HIV: Experiences With HIV Testing, Treatment, and Viral Load Suppression in Four High-Prevalence Countries in Sub-Saharan Africa. Front Public Health. 2022 May 16;10:861431. doi: 10.3389/fpubh.2022.861431.
23. Coghill AE, Newcomb PA, Madeleine MM, Richardson BA, Mutyaba I, Okuku F, Phipps W, Wabinga H, Orem J, Casper C. Contribution of HIV infection to mortality among cancer patients in Uganda. AIDS. 2013 Nov 28;27(18):2933-42. doi: 10.1097/01. aids.0000433236.55937.cb. PMID: 23921614;
24. Asombang AW, Chishinga N, Nkhoma A, Chipaila J, Nsokolo B, Manda-Mapalo M, Montiero JFG, Banda L, Dua KS. Systematic review and meta-analysis of esophageal cancer in Africa: Epidemiology, risk factors, management and outcomes. World J Gastroenterol. 2019 Aug 21;25(31):4512-4533. doi: 10.3748/wjg.v25.i31.4512
2. Uhlenhopp DJ, Then EO, Sunkara T, Gaduputi V. Epidemiology of esophageal cancer: update in global trends, etiology and risk factors. Clin J Gastroenterol. 2020 Dec;13(6):1010-1021. doi: 10.1007/s12328-020-01237-x.)
3. Cheng ML, Zhang L, Borok M, Chokunonga E, Dzamamala C, Korir A, Wabinga HR, Hiatt RA, Parkin DM, Van Loon K. The incidence of oesophageal cancer in Eastern Africa: identification of a new geographic hot spot?. Cancer Epidemiol. 2015;39(2):143-9;
4. Ferlay J, Ervik M, Lam F, et al. Global cancer observatory: cancer today. International Agency for Research on Cancer, Lyon, France. Available from: https://gco.iarc.fr/today. Accessed 08 August 2022.
5. Global Burden of Disease Cancer Collaboration. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: a systematic analysis for the global burden of disease study. JAMA Oncol. 2017;3:524–48.
6. Lorenzoni C, Vilajeliu A, Carrilho C, et al: Trends in cancer incidence in Maputo, Mozambique,1991-2008. PLoS One 2015; 10: e0130469. DOI: 10.1371/journal.pone.0130469
7. Mbulaiteye SM, Katabira ET, Wabinga H, Parkin DM, Virgo P, Ochai R, et al. Spectrum of cancers among HIV-infected persons in Africa: the Uganda AIDS-Cancer Registry Match Study. Int J Cancer. 2006; 118:985–90. [PubMed: 16106415];
8. Loots, E., Sartorius, B., Madiba, T. E., Mulder, C. J. J. & Clarke, D. L. 2017. Oesophageal squamous cell cancer in a South African tertiary hospital: a risk factor and presentation analysis. South African Journal of Surgery 55(3): 42–46
9. Kayamba, V., Bateman, A. C., Asombang, A. W., Shibemba, A., Zyambo, K., Banda, T., Soko, R. & Kelly, P. 2015. HIV infection and domestic smoke exposure, but not human papillomavirus, are risk factors for esophageal squamous cell carcinoma in Zambia: A case-control study. Cancer Medicine 4(4): 588–595,
10. Jensen BE, Oette M, Haes J, Häussinger D. HIV-Associated Gastrointestinal Cancer. Oncol Res Treat. 2017;40(3):115-118. doi: 10.1159/000456714
11. Nutor JJ, Duodu PA, Agbadi P, Duah HO, Oladimeji KE, Gondwe KW. Predictors of high HIV+ prevalence in Mozambique: A complex samples logistic regression modeling and spatial mapping approaches. PLoS One. 2020 Jun 4;15(6):e0234034. doi: 10.1371/journal.pone.0234034. Erratum in: PLoS One. 2020 Jun 25;15(6):e0235456. PMID: 32497145; PMCID: PMC7272061.
12. Come J, Castro C, Morais A, Cossa M, Modcoicar P, Tulsidâs S, Cunha L, Lobo V, Morais AG, Cotton S, Lunet N, Carrilho C, Santos LL. Clinical and Pathologic Profiles of Esophageal Cancer in Mozambique: A Study of Consecutive Patients Admitted to Maputo Central Hospital. J Glob Oncol. 2018 Nov;4:1-9. doi: 10.1200/JGO.18.00147.
13. Cunha Lina, Fontes Filipa, Come Jotamo, Lobo Vitória, Santos Lúcio Lara, Lunet Nuno, Carrilho Carla (2022) Risk factors for oesophageal squamous cell carcinoma in Mozambique ecancer 16 1437
14. Thrift AP, Kramer JR, Hartman CM, Royse K, Richardson P, Dong Y, Raychaudhury S, Desiderio R, Sanchez D, Anandasabapathy S, White DL, Chiao EY. Risk and Predictors of Esophageal and Stomach Cancers in HIV-Infected Veterans: A Matched Cohort Study. J Acquir Immune Defic Syndr. 2019 Jul 1;81(3):e65-e72. doi: 10.1097/QAI.0000000000002038.).
15. Ranjit S, Kumar S. Recent advances in cancer outcomes in HIV-positive smokers. F1000Res. 2018;7:F1000 Faculty Rev-718. Published 2018 Jun 11. doi:10.12688/f1000research.12068.1
16. McCormack VA, Menya D, Munishi MO, et al.: Informing etiologic research priorities for squamous cell esophageal cancer in Africa: A review of setting-specific exposures to known and putative risk factors. Int J Cancer. 2017;140(2):259–71. 10.1002/ijc.30292
17. Moses A, Mwafongo A, Chikasema M, et al.: Risk factors for common cancers among patients at Kamuzu Central Hospital in Lilongwe, Malawi: A retrospective cohort study. Malawi Med J. 2017;29(2):136–41.).
18. Helleberg M, Gerstoft J, Afzal S, et al.: Risk of cancer among HIV-infected individuals compared to the background population: impact of smoking and HIV. AIDS. 2014;28(10):1499–508
19. Park LS, Tate JP, Sigel K, et al.: Time trends in cancer incidence in persons living with HIV/AIDS in the antiretroviral therapy era: 1997-2012. AIDS. 2016;30(11):1795–806. 10.1097/QAD.0000000000001112
20. Ana Catarina Luz , Sophia Baumert , Janet Fisher , Isla Grundy , Maria Matediane , Genevieve Patenaude , Natasha Ribeiro, Casey Ryan , Frank Vollmer , Emily Woollen1 , Pedro Zorrilla Charcoal production and trade in southern Mozambique: historical trends and present scenarios XIV WORLD FORESTRY CONGRESS, Durban, South Africa, 7-11 September 2015, DOI: 10.13140/RG.2.1.1677.8729
21. Nutor JJ, Duodu PA, Agbadi P, Duah HO, Oladimeji KE, Gondwe KW (2020) Predictors of high HIV+ prevalence in Mozambique: A complex samples logistic regression modeling and spatial mapping approaches. PLoS ONE 15(6): e0234034. https://doi.org/10.1371/journal.pone.0234034.
22. Wiginton JM, Mathur S, Gottert A, Pilgrim N, Pulerwitz J. Hearing From Men Living With HIV: Experiences With HIV Testing, Treatment, and Viral Load Suppression in Four High-Prevalence Countries in Sub-Saharan Africa. Front Public Health. 2022 May 16;10:861431. doi: 10.3389/fpubh.2022.861431.
23. Coghill AE, Newcomb PA, Madeleine MM, Richardson BA, Mutyaba I, Okuku F, Phipps W, Wabinga H, Orem J, Casper C. Contribution of HIV infection to mortality among cancer patients in Uganda. AIDS. 2013 Nov 28;27(18):2933-42. doi: 10.1097/01. aids.0000433236.55937.cb. PMID: 23921614;
24. Asombang AW, Chishinga N, Nkhoma A, Chipaila J, Nsokolo B, Manda-Mapalo M, Montiero JFG, Banda L, Dua KS. Systematic review and meta-analysis of esophageal cancer in Africa: Epidemiology, risk factors, management and outcomes. World J Gastroenterol. 2019 Aug 21;25(31):4512-4533. doi: 10.3748/wjg.v25.i31.4512
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2024-07-29
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