Saturday, January 30, 2016

HPV Prevalence in HIV Patients with Head and Neck Squamous Cell Carcinoma

OBJECTIVE:
The implication of HPV in head and neck squamous cell carcinoma (HNSCC) is well established, especially in oropharyngeal SCC. HIV patients have a higher risk of persistent HPV infection. We investigated the role of HPV in HNSCC carcinogenesis in HIV population.

DESIGN:
Retrospective monocentric study.

METHODS:
We studied HIV patients who presented with HNSCC between 1994 and 2014. For each patient, tumor characteristics, HIV disease and survival information were collected. Tumor HPV testing was performed using p16 immunohistochemistry, in situ hybridation and PCR. We assessed the percentage of HPV in this population of HIV patients with HNSCC and compared HIV disease characteristics based on HPV status.

RESULTS:
Forty seven patients were included: 11 women/36 men, the median age was 50 years. Tumor HPV testing was performed in 40 patients. Tumors were located in oropharynx (32%), oral cavity (32%), larynx (21%) and hypopharynx (11%). At the time of diagnosis, median CD4 level was 385/mm, 31% of the patients were stage CDC C. The percentage of HPV linked to HNSCC for all locations in HIV patients was 30% (n = 12). HPV16 accounted for 50% of all HPV genotypes. HPV positive status was associated with a CD4 nadir of less than 200 (p = 0.026), but not with CD4 level at time of diagnosis (p = 0.414). HPV negative tumors tend to be associated with poorer 5-year overall survival (HR = 2.9, p = 0.0711).

CONCLUSION:
HPV plays a critical role in HNSCC development in HIV population. HIV immunodeficiency may increase HPV persistence and progression of HNSCC.

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  • 1Department of ENT, Bichat Hospital, Paris, France, Paris Diderot University, Paris 7 Department of pathology, European G Pompidou Hospital, APHP, Paris, France, Paris Descartes University, Paris 5 Department of Anatomical pathology, Bichat Hospital, Paris, France, Paris Diderot University, Paris 7 Department of Virology, European G Pompidou Hospital, APHP, Paris, France, Paris Descartes University, Paris 5 Department of Epidemiology and Clinical Research, Bichat Hospital, Paris, France, Paris Diderot University, Paris 7.
  •  2016 Jan 23. 




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