Incidence and survival for oropharynx and non-oropharynx head and neck cancers among veterans living with HIV.
Incidence and survival for oropharynx and non-oropharynx head and neck cancers among veterans living with HIV.
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DOI：
10.1002/cam4.3539
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发表时间：
2020-12
期刊：
影响因子：
4
通讯作者：
Chiao E
中科院分区：
文献类型：
--
作者：
Mazul AL;Hartman C;Kramer J;White DL;Royse K;Raychaudhury S;Sandulache V;Ahmed ST;Richardson P;Sikora AG;Chiao E
与美国普通人群相比，艾滋病毒/艾滋病（PLWH）感染者患头颈部鳞状细胞癌（HNSCC）的风险过高，但对与HNSCC发病率和结局相关的HIV特异性风险因素知之甚少。我们的目标是分别确定与口咽和非口咽HNSCC发病率和结局相关的临床和HIV特异性风险因素。我们从1999年至2015年的国家退伍军人事务部（VA）公司数据中对45，052名18岁或以上的PLWH进行了回顾性队列研究。我们提取了人口统计学数据和风险因素信息，包括酗酒史、吸烟史、CD 4计数（细胞/μl）和HIV病毒载量检测不到的随访时间百分比作为时间更新变量。我们计算了口咽和非口咽HNSCC的年龄标准化发病率，并估计了调整后的风险比（HR）。我们还使用Kaplan-Meier曲线和校正的HR检查了总生存率。在PLWH的退伍军人队列中，口咽和非口咽HNSCC的标准化发病率分别为23.0（95%置信区间（CI）：17.1 - 28.9）和55.4（95% CI：46.5 - 64.3）/100，000人年。最低CD 4计数≤200与非口咽HNSCC风险增加相关（HR：1.78; 95% CI：1.31 - 2.30 vs >200）。OPSCC的5年总生存率（37.0%）显著低于非口咽HNSCC（49.1%）。在VA接受治疗的PLWH的年龄调整后HNSCC发病率高于一般人群，表明HIV和免疫抑制发挥了作用。应该进行更多的研究来研究HPV和HIV之间的相互作用。VA医疗保健系统中艾滋病毒感染者的口咽癌和非口咽头颈癌风险升高以及生存率低表明宿主免疫系统与吸烟和HPV相互作用。
People living with HIV/AIDS (PLWH) have an excess risk for head and neck squamous cell carcinoma (HNSCC) compared to the general U.S. population, but little is known about HIV‐specific risk factors associated with the incidence and outcomes HNSCC. We aim to identify clinical and HIV‐specific risk factors associated with oropharyngeal and non‐oropharyngeal HNSCC incidence and outcomes separately. We constructed a retrospective cohort study of 45,052 PLWH aged 18 or above from the national Veteran Affairs (VA) Corporate Data from 1999 to 2015. We extracted demographic data and risk factor information, including history of alcohol abuse, smoking, CD4 count (cells/μl), and percent of follow‐up time with undetectable HIV viral load as time‐updated variables. We calculated the age‐standardized incidence rates of oropharyngeal and non‐oropharyngeal HNSCC and estimated adjusted hazard ratios (HR). We also examined overall survival using Kaplan–Meier curves and adjusted HR. The standardized incidence rate of oropharyngeal and non‐oropharyngeal HNSCC in this veteran cohort of PLWH is 23.0 (95% confidence intervals (CIs): 17.1‐28.9) and 55.4 (95% CI: 46.5‐64.3) per 100,000 person‐years, respectively. Nadir CD4 count ≤200 was associated with an increased risk of non‐oropharyngeal HNSCC (HR: 1.78; 95% CI: 1.31‐2.30 vs >200). Five‐year overall survival of OPSCC (37.0%) was significantly lower than non‐oropharyngeal HNSCC (49.1%). PLWH who receive care in the VA had higher age‐adjusted HNSCC incidence rates than reported in the general population, suggesting that HIV and immunosuppression play a role. Additional studies should be conducted to study the interaction between HPV and HIV. The elevated risk of both oropharynx cancer and non‐oropharyngeal head and neck cancer and poor survival among people living with HIV in the VA healthcare system suggests the host immune system interacts with smoking and HPV.
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DOI：
10.1016/s2352-3018(17)30125-x
发表时间：
2017-11
期刊：
The lancet. HIV
影响因子：
--
作者：
Hernández-Ramírez RU;Shiels MS;Dubrow R;Engels EA
通讯作者：
Engels EA
影响因子：
4.6
作者：
Lifson, Alan R;Lando, Harry A
通讯作者：
Lando, Harry A
DOI：
10.1016/j.wjorl.2017.12.011
发表时间：
2018-12-01
期刊：
World journal of otorhinolaryngology - head and neck surgery
影响因子：
--
作者：
Anis, Mursalin M;Razavi, Mir-Muhammad;Soliman, Ahmed M S
通讯作者：
Soliman, Ahmed M S
影响因子：
1.9
作者：
Sandulache, Vlad C.;Wilde, David C.;Sikora, Andrew G.
通讯作者：
Sikora, Andrew G.
影响因子：
39.2
作者：
Patel, Pragna;Hanson, Debra L.;Brooks, John T.
通讯作者：
Brooks, John T.