Is obesity a risk for anal neoplasia in a group of HIV-infected Hispanics from Puerto Rico?

Background: Obesity has been associated with the development of cancer, including cervical cancer, probably due metabolic dysregulation and chronic inflammation. Given the similarity in the pathophysiology of cervical and anal neoplasia, we aimed at evaluating if overweight (BMI: 25–29.9 kg/m2) and obesity (BMI ≥30 kg/m2) are a risk for anal high-grade squamous intraepithelial lesions (HSIL) in a group of HIV-infected Hispanics from Puerto Rico. Methods: A cross-sectional study was performed using data from the medical records of 291 HIV-positive patients of the Anal Neoplasia Clinic of the University of Puerto Rico Comprehensive Cancer Center from June 2015 to April 2018. Logistic regression models were used to estimate the odds ratio (OR) with 95% confidence intervals (CI) for estimating the association between overweight and obesity with HSIL (based on histopathology and based on the definition of the LAST project), controlling for potential confounders. Results: Overall, 35.4% and 25.1% of patients were overweight and obese, respectively. The prevalence of HSIL was 45.2% among under/normal weight patients, 36.9% among overweight patients and 35.6% for obese patients (p-trend=0.16). Although decreased odds of HSIL were observed among overweight (OR=0.67, 95% CI=0.37–1.21) and obese (OR=0.71, 95% CI=0.36–1.38) patients than under/normal weight patients after adjusting for age, gender, history of diabetes, and having > 10 lifetime sexual partners, these results were not statistically significant. Conclusions: Overweight and obesity are frequent among our patients, but we found no significant association between overweight/obesity and HSIL. Although our study may be limited in sample size, future studies should further assess this association and the potential biological mechanisms for it.