@article{036dc8cd8399461d873c6e68f64077f2,
title = "Incidence and risk factors of HPV-related and HPV-unrelated Head and Neck Squamous Cell Carcinoma in HIV-infected individuals",
abstract = "Objectives To examine the risk and trends of HPV-related and HPV-unrelated Head and Neck Squamous Cell Carcinoma (HNSCC) in HIV-infected individuals and assess whether immunosuppression (measured through CD4 cell count) and other risk factors impact HNSCC risk.Materials and methods Incident HNSCCs at HPV-related and HPV-unrelated anatomic sites were detected in HIV-infected participants from pooled data from 17 prospective studies in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) between 1996 and 2009. HNSCC cases were validated using chart review or cancer registry matching. Risk factors for incident HPV-related and HPV-unrelated HNSCC were explored using mixed effects Poisson regression in a full prospective analysis, and the effect of CD4 prior to cancer diagnosis was examined in a nested case control analysis.Results 66 HPV-related and 182 HPV-unrelated incident HNSCCs were detected among 82,375 HIV-infected participants. Standardized incidence ratios (SIRs) for both HPV-related (SIR = 3.2, 95%CI = 2.5-3.4) and HPV-unrelated (SIR = 3.0, 95%CI = 2.5-4.1) HNSCC were significantly elevated in HIV-infected individuals compared with the US general population. Between 1996 and 2009, the age-standardized HPV-related HNSCC incidence increased non-significantly from 6.8 to 11.4 per 100,000 person-years (p-trend = 0.31) while the age-standardized incidence of HPV-unrelated HNSCC decreased non-significantly from 41.9 to 29.3 per 100,000 person-years (p-trend = 0.16). Lower CD4 cell count prior to cancer diagnosis was significantly associated with increased HPV-related and HPV-unrelated HNSCC risk.Conclusion The standardized incidence of HPV-related and HPV-unrelated HNSCC are both elevated in HIV-infected individuals. Immunosuppression may have a role in the development of both HPV-related and HPV-unrelated HNSCC.",
keywords = "CD4 T cell count, HIV, HPV, Head and Neck Squamous Cell Carcinoma, NA-ACCORD, Oropharyngeal cancer",
author = "Beachler, {Daniel C.} and Abraham, {Alison G.} and Silverberg, {Michael J.} and Yuezhou Jing and Carole Fakhry and Gill, {M. John} and Robert Dubrow and Kitahata, {Mari M.} and Klein, {Marina B.} and Burchell, {Ann N.} and Korthuis, {P. Todd} and Moore, {Richard D.} and Gypsyamber D'Souza",
note = "Funding Information: National Institute of Allergy & Infectious Diseases, with supplemental funding from the National Cancer Institute. This work was supported by grants: U01-AI069918, U01-AA013566, U24-AA020794, U01-AA020790, U01-AI31834, U01-AI34989, U01-AI34993, U01-AI34994, U01-AI35004, U01-AI35039, U01-AI35040, U01-AI35041, U01-AI35042, U01-AI35043, U01-AI37613, U01-AI37984, U01-AI38855, U01-AI38858, U01-AI42590, U01-AI68634, U01-AI68636, U01-AI69432, U01-AI69434, U01-HD32632, U10-EY08057, U10-EY08052, U10- EY08067, UL1-RR024131, UL1-TR000083, U54- MD007587, F31-DA035713, G12- MD007583, K01-AI071754, K01-AI093197, K23 EY013707, K24–00432, MO1-RR-00052, N02-CP55504, P30-AI027763, P30-AI094189, P30-AI27757, P30-AI27767, P30-AI50410, P30-AI54999, P30-AI036219, P30-MH62246, R01-CA165937, R01-AA16893, R01-DA11602, R01-DA04334, R01-DA12568, R24-AI067039, R56-AI102622, Z01-CP010214, and Z01-CP010176 from the National Institutes of Health, USA; contract CDC200–2006-18797 from the Center{\textquoteright}s for Disease Control and Prevention, USA; contract 90047713 from the Agency for Healthcare Research and Quality, USA; contract 90051652 from the Health Resources and Services Administration, USA; grants TGF-96118, HCP-97105, CBR-86906, CBR-94036 from the Canadian Institutes of Health Research, Canada; Ontario Ministry of Health and Long Term Care; and the Government of Alberta, Canada. The lead author is funded through T32 CA CA009314. Funding Information: Michael Silverberg has ongoing grants from Pfizer and Merck, Gypsyamber D{\textquoteright}Souza received previous received funding from Merck, John Gill is a board member of BMS Abbvie, Janssen, and Gilead Viiv, and Marina Klein has consulted with Glaxo Smith Klein and VIIV and has a current grant with Merck. For the remaining authors no conflicts of interest were declared. Publisher Copyright: {\textcopyright} 2014 Elsevier Ltd.",
year = "2014",
month = dec,
day = "1",
doi = "10.1016/j.oraloncology.2014.09.011",
language = "English (US)",
volume = "50",
pages = "1169--1176",
journal = "Oral Oncology",
issn = "1368-8375",
publisher = "Elsevier Limited",
number = "12",
}