The Prevalence of High-Risk HPV in Aerodigestive and Lung Cancers in HIV+ Patients
Taylor M Deal, Tatyana Isayeva, James Willig, Margaret Brandwein-Gensler. University of Alabama, Birmingham, AL
Background: The incidences of lung cancer and head and neck squamous cell carcinoma (HNSCC) are significantly higher in patients infected with the human immunodeficiency virus (HIV). Previous studies suggest that high-risk Human Papillomavirus (HR-HPV) may be important in the pathogenesis of lung cancer in immune-competent individuals. The prevalence of HR-HPV in lung cancers of HIV+ patients has not yet been studied, and only two small cohorts of HIV+ patients with HNSCC have been studied for HR-HPV. It is important and novel to study a large cohort of HIV+ patients with these cancers as there are therapeutic implications for HR-HPV-mediated cancers.
Design: The UAB databases for the outpatient AIDS clinic and pathology department were queried. The diagnoses of HIV were confirmed by CD4-counts and/or viral loads. The histological diagnoses were reviewed and confirmed. Nucleic acids were extracted from archived specimens. Only specimens with positive internal nucleic acid controls (GAPDH) were studied further for HPV. Nested polymerase chain reactions (PCR) were performed with GP5/6 consensus primers. Reverse transcription and nested real-time PCR (RT-PCR) were performed with HPV16/18 E6/E7 primers. Tumors were classified as positive only if both concordant E6/E7 reactions were positive. Positive controls (HeLa, SiHa, HPV16+ HNSCC) and negative controls (cirrhotic liver, pancreatic, colonic, renal carcinomas and water) were included in all reactions, which were run in duplicate.
Results: We identified 14 HIV+ patients (11 males, three females) ages 26-67 (median 49.5 years). Seven patients had lung cancer (adenosquamous), and 7 had HNSCC (5 oral cavity, 2 larynx). Thirteen tumors were positive using the GP5/6 primers, with appropriately reactive controls; the agarose gel bands demonstrated slightly different sizes, as is expected, indicating different HPV-types. Two tumors were HPV16+ (1 lung, 1 larynx), 4 tumors were HPV18+, (3 lung, 1 oral cavity), 6 tumors were HPV16/18+ (3 lung, 2 oral cavity, 1 larynx). One oral cavity cancer was positive by GP5/6 primers, but negative for HPV 16/18, indicating a different HPV-type. One tumor was HPV18+ (oral cavity); results are pending for HPV16 and GP5/6.
Conclusions: This preliminary study indicates that transcriptionally active HPV16/18 is common in HNSCC and lung cancers for this population, which may be an important disease-modifying factor. Future goals include the study of a larger cohort, with matched HIV-negative patients.
Category: Head & Neck
Wednesday, March 21, 2012 9:30 AM
Poster Session V # 178, Wednesday Morning