and Human Immunodeficiency Virus Co-Infection: Potential Implications for Future Gastric Cancer Risk.

Objective: and human immunodeficiency virus (HIV) are both pandemic infections with variable geographic prevalence rates. -HIV co-infection at the regional and sub-regional levels with a perspective on gastric cancer incidence is discussed.

Design: Based on PRISMA guidelines, national data for , HIV, and -HIV co-infection were collected for the general population through December 2019. Joint temporal and geographical data for and HIV infections in 48 countries were available and used to generate -HIV co-infection estimates by cross-sectional analysis. These data were compared with gastric carcinoma statistics for the same countries.

Results: The estimated global prevalence rate of -HIV co-infection was 1.7 per 1000 people, representing 12.6 million people. Prevalence according to region was, in decreasing order, sub-Saharan Africa 21.9‱, Eastern Europe/Central Asia 4.3‱, Latin America/Caribbean 2.0 ‱, North America/Western/Southern/Northern Europe 1.1‱, Asia/Pacific 0.8‱, and North Africa/Middle East 0.1 ‱. The incidence and mortality rates for gastric carcinoma were higher in East/Pacific Asia, Southern/Andean Latin America, and Eastern Europe regions, and the incidence appeared to be 1.8-fold greater in -HIV-infected people in East Asia.

Conclusions: The population at risk of -HIV co-infection is estimated to be 12.6 million people (2015 reference year). The heterogeneity of -HIV co-infection across regions and sub-regions does not show a clear association with gastric carcinoma. Other methodological approaches with analytical studies (cohort, case-control) are required to measure the potential effect of infection and its treatment on the incidence of gastric carcinoma in the large HIV--positive cohort.