title: Impact of HIV infection on colorectal tumors: a prospective colonoscopic study of Asian patients.
abstract: BACKGROUND
  Non-AIDS defining cancer has recently become a major problem in HIV-infected patients. Little has been reported on whether HIV infection is a risk factor for colorectal adenoma, especially in Asians.
  
  
  METHODS
  The study was conducted under a prospective cross-sectional design and included all adults who underwent colonoscopy. Subjects were matched by age and sex to compare the prevalence of colorectal adenoma, adenocarcinoma, polyps, and other tumors. Detailed risk factors were assessed, including lifestyle habits, medications, comorbidities, gastrointestinal symptom rating scale, HIV-associated factors, and human papillomavirus infection. To evaluate the effects of HIV infection on adenoma, the odds ratio (OR) was estimated by multivariate logistic regression.
  
  
  RESULTS
  A total of 177 HIV-infected patients and 177 controls were selected for analysis. No significant difference was noted in the prevalence of adenoma (n = 29 vs. 40, P = 0.14). Multivariate analysis adjusted by baseline demographics and risk factors showed that HIV is not associated with increased risk of adenoma (adjusted OR = 0.66, P = 0.16). Kaposi's sarcoma was more common in HIV-infected patients (n = 6 vs. 0, P = 0.03). Among HIV-infected patients, advanced age was an independent and significant risk factor for adenoma (adjusted OR = 2.28, P < 0.01). CD4 count, HIV-RNA, history of antiretroviral treatment, and oncogenic human papillomavirus infection were not risk factors for adenoma.
  
  
  CONCLUSIONS
  HIV infection was not identified as risk for adenoma in Asian patients. However, advanced age was independently associated with increased risk of adenoma. HIV-infected patients should not miss screening opportunity for colorectal adenoma and other gastrointestinal malignancies.
authors: *AIDS Clinical Center and †Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan; ‡Center for AIDS Research, Kumamoto University, Kumamoto, Japan; §Research and Informatics, International Clinical Research Center Research Institute, and ‖Pathology Division of Clinical Laboratory, National Center for Global Health and Medicine, Tokyo, Japan; and ¶The Research Center for Hepatitis and Immunology, Department of Gastroenterology and Hepatology, and #Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Kohnodai Hospital, Chiba, Japan.
authors: Yohei
authors: Y
authors: Hamada
authors: Naoyoshi
authors: N
authors: Nagata
authors: Takeshi
authors: T
authors: Nishijima
authors: Takuro
authors: T
authors: Shimbo
authors: Naoki
authors: N
authors: Asayama
authors: Yoshihiro
authors: Y
authors: Kishida
authors: Katsunori
authors: K
authors: Sekine
authors: Shohei
authors: S
authors: Tanaka
authors: Tomonori
authors: T
authors: Aoki
authors: Kazuhiro
authors: K
authors: Watanabe
authors: Junichi
authors: J
authors: Akiyama
authors: Toru
authors: T
authors: Igari
authors: Masashi
authors: M
authors: Mizokami
authors: Naomi
authors: N
authors: Uemura
authors: Shinichi
authors: S
authors: Oka
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology; D000328:Adult; D000367:Age Factors; D001208:Asia / Q000453:epidemiology; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000175:diagnosis; D011446:Prospective Studies; D012307:Risk Factors