HIV-associated squamous cell carcinoma of the head and neck (HNSCC) is biologically distinct from HNSCC in non-HIV-infected patients, according to a study published in Cancer.1 The biological qualities of HIV-positive-associated HNSCC may, furthermore, be therapeutically relevant.

Oncogenic virus–associated cancers are nearly 10 times more common in HIV-positive patients, and usually carry a worse prognosis. The prevalence of human papillomavirus (HPV) is linked to many of these cases, and may display unique molecular characteristics not associated with HNSCCs in patients who are HIV-negative/HPV-negative.

To determine whether any biological features render HPV-associated HSNCC in HIV-positive patients more aggressive, researchers analyzed DNA samples from 20 HIV-positive patients with HNSCC and 32 HIV-negative patients with HNSCC. Eighteen genes frequently mutated in HNSCC, including HRAS, TP53, and PIK3CA, were sequenced; noted mutations were compared between the groups.

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Nine patients were HIV-positive and HPV-positive; 11 patients were HIV-positive and HPV-negative; 6 patients were HIV-negative and HPV-positive; 26 patients were HIV-negative and HPV-negative. Nearly 85% of samples had at least 1 noted genetic mutation.

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Regardless of HIV status, HPV-negative cancers had a higher number of noted mutations; 100% of HPV-negative/HIV-negative patients had mutations vs 81.8% of HPV-negative/HIV-positive patients.

HIV-positive patients had significantly lower rates of TP53 mutations, suggesting that HIV-related HNSCC is biologically distinct from non-HIV-related cases. Survival differences were not, however, noted between patients with differing TP53-status.

The authors noted that, while “our small sample size might limit definitive conclusions on the impact of such variables on the survival of HNSCC patients…studies are needed to understand the unique etiology, pathogenesis, and biology of these tumors and to determine whether there are unique therapeutic modalities that would benefit these HNSCC patients.”


  1. Gleber-Netto FO, Zhao M, Trivedi S, et al. Distinct pattern of TP53 mutations in human immunodeficiency virus–related head and neck squamous cell carcinoma. Cancer. 2017 Oct 20. doi: 10.1002/cncr.31063 [Epub ahead of print]