Cancer
Disparities in oropharyngeal cancer survival outcomes between individuals living with and without HIV Amelia Nichols* Amelia Nichols Vivian Vo Jessica Islam Jesse Qualliotine Brittney L. Dickey
Human Papillomavirus (HPV) is the primary etiologic agent responsible for the majority of oropharyngeal cancer (OPC) cases in the United States. People with HIV (PWH) face an elevated risk for HPV infection and HPV-associated malignancies. However, the impact of HIV status on survival following a diagnosis of HPV-OPC remains unknown. The objective of this study was to explore differences in HPV-OPC survival among people living with and without HIV (PWoH).
Data from the National Cancer Database (NCDB) was used to identify patients diagnosed with oropharyngeal cancer (ICD-0-3 codes: C01.9, C02.4, C05.1, C052, C09.0-9.1, C09.8-9.9, C10.0-10.4, C10.8-10.9, C14.2) with a positive result for HPV-DNA to a high-risk type. PWH were identified using ICD9 (04200 to 04499, 07953, and V08) and ICD10 (B20 to B24, R75, Z21, B97.35) codes. Demographics (sex, age, race), cancer stage, and treatment receipt was descriptively compared by HIV status. Kaplan Meier curves assessed survival time after cancer diagnosis by HIV status and treatment received (surgery, radiation, chemotherapy, and immunotherapy).
There were 146,539 individuals identified with HPV-OPC of which 163 were living with HIV and 24,401 without HIV. Significant differences were observed between the two groups in demographics, stage, and treatment received (p <0.0001). PWoH experienced better overall survival than PWH (p <0.0001). Additionally, stratification by treatment type revealed that PWH had worse survival outcomes across all modalities including surgery, radiation, chemotherapy, and immunotherapy (p <0.0001).
HIV status is associated with significant disparities in survival among individuals with HPV-OPC. Those with HIV have worse overall survival and after stratifying by cancer treatment type. These findings underscore the need for further research to better understand the underlying factors driving these disparities and to develop interventions aimed at improving survival in this vulnerable population.