Alterations in head and neck cancer occurring in HIV-infected patients - Results of a pilot, longitudinal, prospective study

To assess the impact of human immunodeficiency virus (HIV) infection on the presentation and course of head and neck squamous cell carcinoma (HNSCC), we performed a pilot. prospective, longitudinal study of all patients with HNSCC presenting to our institutions over a 6-month period (n = 10). A 60% incidence of HIV infection was seen in this study population, with SCC pres enting as the initial manifestation of HIV infection in 2 of the 6 patients . In addition, HIV-infected patients were significantly younger than non-in fected patients at (p = 0.01). None of the HIV-infected patients had acquir ed immunodeficiency syndrome (AIDS) at the time of presentation, but 5 of 6 patients had an abnormal CD4 count, compared to none of the non-infected p atients (p = 0.05). The absolute CD4 count in HIV-infected patients decreas ed to less than 100 x 10(9)/L in the majority of these patients within 3 mo nths of presentation with HNSCC (p = 0.05). Treatment-associated complicati ons were common in HIV-infected patients, occurring in 4 of the 6 cases in contrast to none of the patients without HIV infection (p = 0.046). Outcome was significantly poorer for HIV-Infected patients, with 5 patients succum bing to their disease within one year, in contrast to none of the non-infec ted patients (p = 0.046). These data, combined with our previous work, just ify further investigation of the relationship between HNSCC and HIV infecti on and the possibility of its inclusion as an AIDS-defining process.