In the Journals Plus

HIV-infected Hispanics at greater risk for HPV-related cancers

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December 26, 2018

HIV-infected Hispanic adults in the United States demonstrated a higher risk for HPV-related cancers than Hispanics who did not have HIV, according to a study published in Cancer.

Ana Patricia Ortiz, PhD, researcher at University of Puerto Rico Comprehensive Cancer Center, and colleagues contend their findings highlight the need for more HPV vaccination and cancer screening programs for individuals with HIV, as well as more research into racial and ethnic disparities in HPV-related cancer incidence.

“[People living with HIV] have elevated rates of HPV-associated cancers because of the high incidence and persistence of HPV infections that occur as a result of immunosuppression, and this promotes carcinogenesis and tumor development,” Ortiz and colleagues wrote.

HPV causes 10% of cancers among HIV-infected individuals in the United States, Hispanics are disproportionately affected by the HIV epidemic, as well as infection-related cancers, according to study background.

Approximately 22% of all people living with HIV in the United States in 2015 were Hispanic. Researchers used data from the HIV/AIDS Cancer Match Study to The data were gathered from HIV and cancer registries in Colorado, Connecticut, Georgia, Maryland, Michigan, New Jersey, New York, Puerto Rico and Texas between 1996 and 2012.

The risk for HPV-related cancers, with the exception of oropharyngeal cancer, was higher among HIV-infected Hispanics than among the general population, with standard incidence ratios ranging from 3.59 for cervical cancer to 18.7 for anal cancer among men.

Among HIV-infected individuals, researchers compared rates of HPV-related cancers and survival outcomes among Hispanics with non-Hispanic whites and non-Hispanic blacks.

Researchers found that 502 HPV-related cancers occurred during 864,067 person-years of follow up among HIV-infected Hispanics. Males accounted for most of the person-years among Hispanics (71.7%), non-Hispanic whites (84.6%) and non-Hispanic blacks (63.7%).

The most common HPV-related cancers among Hispanics with HIV were cervical cancer among women (56 cases per 100,000) and anal cancer among men (35.2 cases per 100,000). These cancers also were the most common among the other populations in the study.

Among HIV-infected females, Hispanics had higher rates of cervical cancer than non-Hispanic whites (incidence rate ratio [IRR] = 1.7; 95% CI, 1.19-2.43) but lower rates of vulvar cancer than non-Hispanic whites (IRR = 0.4; 95% CI, 0.24-0.67) and non-Hispanic blacks (IRR = 0.62; 95% CI, 0.41-0.95).

Among HIV-infected males, Hispanics had higher rates of penile cancer than non-Hispanic whites (IRR = 2.6; 95% CI, 1.36-4.96) but lower rates of anal cancer than non-Hispanic whites (IRR = 0.54; 95% CI, 0.46-0.63) and non-Hispanic blacks (IRR = 0.65; 95% CI, 0.56-0.77).

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Approximately half of all HIV-infected individuals with HPV-related cancers survived at least 5 years.

Researchers acknowledged several study limitations, including a lack of available data on cancer risk factors — such as sexual behaviors, vaccinations and cigarette use — and a lack of data on social factors, such as health insurance, education and income. Also, causes of death for patients were not available from all the registries.

“This is the first assessment of HPV-related cancer burden in HIV-infected Hispanics that considers Hispanics living in the continental U.S. and in Puerto Rico,” Ortiz said in a press release. “Our findings show that similar to what is observed among other racial/ethnic groups in the U.S., HIV-infected Hispanics have elevated rates of most HPV-related malignancies as compared [with] Hispanics from the general population.” – by John DeRosier

Disclosures : The study was supported by the Intramural Research Program at NCI. The authors report no relevant financial disclosures.