Prognostic Factors and Survival Outcomes among Oncology Patients with Known and Unknown HIV Status in Kisumu County, Kenya

Abstract

Introduction: Human immunodeficiency virus (HIV) and cancer have a complicated interplay in their pathobiology, resulting in malignancies associated with viral infection. This study sought to establish the prognostic factors and survival outcomes among patients diagnosed with cancer with known and unknown HIV status. Methods: The study employed a hybrid design, combining retrospective and prospective cohorts from 2019 to 2021. Three hundred and seventy-nine cancer patients with known and unknown HIV status enrolled at the oncology clinic in Kisumu County were recruited via multi-stage and stratified sampling. Results: The mean age was 57.2 years (SD 15.2). The study population comprised 31.1% (118) males and 68.9% (261) females. Among the study participants, 53.6% (203) were HIV-negative, 39.8% (151) were HIV-positive, and 6.6% (25) had an unknown HIV status. Multivariable Cox regression showed HIV status had no statistical impact on survival. Metastasis at diagnosis increased the risk of death (HR 3.1, p<0.001, 95% CI 1.7-5.6) as did late cancer stage (HR 3.1, p=0.035, 95% CI 1.1–8.7). Longer duration of care reduced risk of death (HR 0.8, p<0.001, 95% CI 0.7-0.9), as did non-tobacco usage (HR 0.3, p=0.042, 95% CI 0.1-0.9). Conclusion: Tumour stage, metastasis, tobacco use, and duration of care had a statistically significant influence on the survival of the oncology patients.