Published online Sep 16, 2023. doi: 10.4253/wjge.v15.i9.545
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
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.
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.
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.
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.
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.
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.
Further studies and work need to be done to determine if any specific HAART regimen might impact colorectal cancer development.