Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Sep 16, 2023; 15(9): 545-552
Published online Sep 16, 2023. doi: 10.4253/wjge.v15.i9.545
Human immunodeficiency virus patients with low CD4 counts are more likely to have precancerous polyps identified during index colonoscopy
Michelle Likhtshteyn, Evan Marzouk, Fray M Arroyo-Mercado, Gurasees Chawla, Sabrina Rosengarten, Renata Lerer, Hector Ojeda-Martinez, Savanna Thor
Michelle Likhtshteyn, Gurasees Chawla, Savanna Thor, Department of Gastroenterology, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, United States
Evan Marzouk, Department of Internal Medicine and Pediatrics, Baystate Medical Center, Springfield, IL 01199, United States
Fray M Arroyo-Mercado, Department of Gastroenterology, University of New Mexico, Albuquerque, NM 87106, United States
Sabrina Rosengarten, Department of Emergency Medicine, New York-Presbyterian Queens Hospital, Queens, NY 11355, United States
Renata Lerer, Department of Gastroenterology, University of Pennsylvania, Philadelphia, PA 19104, United States
Hector Ojeda-Martinez, Department of Infectious Disease, Nuvance Health-Vassar Brothers Medical Center, Poughkeepsie, NY 12601, United States
Author contributions: Likhtshteyn M, Marzouk E, Arroyo-Mercado FM, Chawla G, and Lerer R contributed equally to this work; Thor S was the research mentor specializing in gastroenterology; Ojeda-Martinez H was the research mentor specializing in Infectious Diseases and HIV; Rosengarten S performed statistical analysis; Likhtshteyn M, Marzouk M, Rosengarten S, and Thor S wrote the manuscript; Likhtshteyn M and Thor S were responsible for revising the manuscript; All authors read and approved the final version.
Institutional review board statement: The project, “Adenoma prevalence, characteristics, and outcomes on screening colonoscopy in patients with HIV in an Urban Safety Net Hospital and Urban University Hospital” was approved by SUNY Downstate Health Sciences IRB on October 13, 2020, No. 1306045.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrollment.
Conflict-of-interest statement: The authors declare having no conflicts of interest for this article.
Data sharing statement: Please contact for all statistical requests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Michelle Likhtshteyn, MD, Academic Fellow, Doctor, Department of Gastroenterology, SUNY Downstate Health Sciences University, 450 Clarkson Ave, Brooklyn, NY 11203, United States.
Received: March 22, 2023
Peer-review started: March 22, 2023
First decision: April 28, 2023
Revised: May 16, 2023
Accepted: August 21, 2023
Article in press: August 21, 2023
Published online: September 16, 2023
Research background

Antiretroviral therapies have improved the life expectancy of patients living with human immunodeficiency virus (HIV). As these patients live longer, they can develop non-acquired immunodeficiency syndrome defining malignancies such as colon cancers.

Research motivation

Some studies have shown that highly active anti-retroviral therapy (HAART) decreases the risk of developing colorectal cancer, while other studies propose that HIV patients are at higher risk and develop colorectal cancer at younger ages. There is no recommendation in gastrointestinal guidelines regarding special screening ages for HIV patients.

Research objectives

Our objective was to identify which factors are associated with the development of precancerous polyps on index screening colonoscopy in patients with HIV and to investigate whether HIV disease severity, measured by viral load and CD4 count, might impact adenoma growth.

Research methods

A retrospective review of electronic medical charts at Kings County Hospital and SUNY Downstate Health Sciences University for patients with HIV who had received a screening colonoscopy between 2005 and 2015 was performed.

Research results

We determined there was an increased rate of precancerous polyps in patients who had lower CD4 counts and those taking non-nucleoside reverse transcriptase inhibitors.

Research conclusions

We determined there was a relationship between HIV disease status and precancerous polys found on colonoscopy. Further studies need to be done to further explore this relationship in patients with HIV.

Research perspectives

Further studies and work need to be done to determine if any specific HAART regimen might impact colorectal cancer development.