Abstract
e13124 Background: Head and Neck Cancer (HNC) is a common non-AIDS defining malignancy and its risk increases by 1.7 to 4-fold with HIV infection. Little is known about the epidemiology and outcomes in this subset of patients. This study was undertaken to evaluate the characteristics of HIV+ HNC in an inner city minority population. Methods: All patients with a diagnosis of HNC from January 2008 to December 2017 were identified from the Tumor Registry Database of Cook County Health. We screened patients for HIV+ status at the time of HNC diagnosis. Retrospective chart review of those with Squamous cell carcinoma (SCC) was performed and compared to the largest reported HIV+ HNC cohort (SPORE consortium – J Acquir Immune Defic Syndr. 2015; 65(5):603-10). Other histologies were not included. Results: A total of 1379 charts were screened and 38 unique HIV+ patients with SCC were identified. The most common tumor sites were oral cavity (34%), larynx (26%) and oropharynx (26%), similar to SPORE. However, our cohort had a higher number of African Americans (AA) and a greater proportion of female patients. The median age of diagnosis was 52 years, which is similar in both studies but much lower than the non-HIV population (SEER database - median age 65). Over 63% had an undetectable viral load (VL) compared to 1.4% in SPORE, but the median CD4 count did not differ (298 vs 300 cells/µL). Survival information was available for 27 patients, with a median of 21 months (mo) versus 49 mo in SPORE. Overall survival (OS) was higher in non-smokers (34.5 mo vs 21 mo) and those with CD4>500 when compared to CD4<100 (42mo vs 15mo) Table summarizes the comparison of data. Conclusions: HIV+ HNC was predominantly seen in AA males. When compared to the SPORE cohort, OS was much poorer in the inner city minority, despite similar median age and CD4 counts. In addition, smokers and those with CD4 <100 cells/µL at diagnosis seem to have worse outcomes. [Table: see text]
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