Outcome of HIV-Infected Patients With Invasive Squamous-Cell Carcinoma of the Anal Canal in the Era of Highly Active Antiretroviral Therapy

Human papillomavirus (HPV) can infect oral mucosa, causing asymptomatic infection or warty lesions. Several case-control studies have confirmed HPV as an independent risk factor for squamous cell carcinoma. HPV-related cancers seem to have better prognoses and different risk factors than do HPV-negative ones. HIV-infected patients are known to be at increased risk for persistent genital and anal high-risk HPV infections and intraepithelial neoplasm. Since the era of highly active antiretroviral therapy, the prevalence and persistence of warty lesions in oral mucosa have increased. Oral squamous cell carcinoma was recently added in the case definitions for common HIV-related oral mucosa lesions. The increased risk of HPV infection in HIV patients has been associated with impaired immune response to HPV, highly active antiretroviral therapy, aging of the HIV-infected patients, and direct interaction between the 2 viruses. HPV32 seems to be much more prevalent in asymptomatic HPV infections and warts among those infected with HIV than among those in the general population. Regarding HIV genes, there is evidence of an interaction between HPV and tat, rev, and vpr. HIV might play a role in HPV-associated pathogenesis by exhorting oncogenic stimuli via tat and rev or visa versa.

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Association of HIV Status With Outcomes of Anal Squamous Cell Carcinoma in the Era of Highly Active Antiretroviral Therapy

JAMA Oncology ◽

10.1001/jamaoncol.2017.2844 ◽

2018 ◽

Vol 4 (1) ◽

pp. 120 ◽

Cited By ~ 8

Author(s):

Alex K. Bryant ◽

Minh-Phuong Huynh-Le ◽

Daniel R. Simpson ◽

Samir Gupta ◽

Andrew B. Sharabi ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Antiretroviral Therapy ◽

Cell Carcinoma ◽

Squamous Cell ◽

Highly Active Antiretroviral Therapy ◽

Hiv Status ◽

Anal Squamous Cell Carcinoma ◽

Highly Active

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Combined Radical Retropubic Prostatectomy and Abdominoperineal Resection for Locally Invasive Squamous Cell Carcinoma of the Anal Canal

Nippon Daicho Komonbyo Gakkai Zasshi ◽

10.3862/jcoloproctology.59.265 ◽

2006 ◽

Vol 59 (5) ◽

pp. 265-269

Author(s):

J. Minohata ◽

T. Hirai ◽

K. Komori ◽

Y. Kanemitu ◽

T. Kato

Keyword(s):

Squamous Cell Carcinoma ◽

Anal Canal ◽

Cell Carcinoma ◽

Abdominoperineal Resection ◽

Squamous Cell ◽

Radical Retropubic Prostatectomy ◽

Invasive Squamous Cell Carcinoma ◽

Retropubic Prostatectomy

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Anal squamous carcinoma: a new AIDS-defining cancer? Case report and literature review

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46652012000600010 ◽

2012 ◽

Vol 54 (6) ◽

pp. 345-348 ◽

Cited By ~ 3

Author(s):

Marcelo Corti ◽

María F. Villafañe ◽

Esteban Marona ◽

Daniel Lewi

Keyword(s):

Antiretroviral Therapy ◽

Anal Canal ◽

Cell Carcinoma ◽

Anal Cancer ◽

Highly Active Antiretroviral Therapy ◽

Anal Carcinoma ◽

Sphincter Muscle ◽

Highly Active ◽

Anal Ultrasound ◽

Hiv Seropositive

Squamous anal cell carcinoma is a rare malignancy that represents the 1.5% to 2% of all the lower digestive tract cancers. However, an increased incidence of invasive anal carcinoma is observed in HIV-seropositive population since the widespread of highly active antiretroviral therapy. Human papillomavirus is strongly associated with the pathogenesis of anal cancer. Anal intercourse and a high number of sexual partners appear to be risk factors to develop anal cancer in both sexes. Anal pain, bleeding and a palpable lesion in the anal canal are the most common clinical features. Endo-anal ultrasound is the best diagnosis method to evaluate the tumor size, the tumor extension and the infiltration of the sphincter muscle complex. Chemoradiotherapy plus antiretroviral therapy are the recommended treatments for all stages of localized squamous cell carcinoma of the anal canal in HIV-seropositive patients because of its high rate of cure. Here we present an HIV patient who developed a carcinoma of the anal canal after a long time of HIV infection under highly active antiretroviral therapy with a good virological and immunological response.

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Squamous Cell Carcinoma of the Lower Lip Complicating a Recurrent Labial Herpes During HIV Infection: a Case Report

International Journal of Clinical & Experimental Dermatology ◽

10.33140/ijced.05.01.01 ◽

2020 ◽

Vol 5 (1) ◽

Keyword(s):

Squamous Cell Carcinoma ◽

Hiv Infection ◽

Cell Carcinoma ◽

Squamous Cell ◽

Highly Active Antiretroviral Therapy ◽

Surgical Excision ◽

Hiv Positive ◽

Epithelial Tumor ◽

Lower Lip ◽

Highly Active

Introduction: Squamous cell carcinoma (SCC) is the main cancer of lips; it is increasingly diagnosed in HIV-positive patients. In most cases, there are factors that promote his occurrence. We report a case of an HIV-positive woman with SCC of the lower lip complicating recurrent labial herpes. Medical observation: It was a case of a 40-year-old female received in consultation for a painful and ulcerous lesion of her lip lasting 5 months. She was a HIV-positive patient diagnose since 2007 and on Highly Active Antiretroviral Therapy since that time. She was taking alcohol, was exposed to sunlight regularly, and had presented many episodes of labial herpes in the past. On clinical examination she had a painful ulcero-crustal medallion measuring 2.5 centimeters in diameter, with a papular edge of pearlescent appearance of the lower lip. Given this clinical picture, the diagnosis of chronic decaying herpes labialis with in differential an epithelial tumor (in particular a squamous cell carcinoma of the lower lip) was mentioned. After surgical excision, an anatomopathological analysis of the part confirmed the diagnosis of squamous cell carcinoma. At the time of diagnosis, the patient had a respective CD4 and CD8 level of 939 and 964 cells / mm3 . The evolution was marked 6 weeks later by the scarring with complete epithelialization of the site of the lesion. Conclusion: SCC of the lips is a frequent cancer occurring during HIV infection; there are many risk factors which promote his occurrence. Earlier the treatment is instituted, better is the prognosis.

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Perianal squamous cell carcinoma with high-grade anal intraepithelial neoplasia in an HIV-positive patient using highly active antiretroviral therapy: case report

Sao Paulo Medical Journal ◽

10.1590/s1516-31802007000500009 ◽

2007 ◽

Vol 125 (5) ◽

pp. 292-294 ◽

Cited By ~ 2

Author(s):

Sergio Carlos Nahas ◽

Caio Sergio Rizkallah Nahas ◽

Edesio Vieira da Silva Filho ◽

Jose Eduardo Levi ◽

Fabio Cesar Atui ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Case Report ◽

Anal Canal ◽

Squamous Cell ◽

Highly Active Antiretroviral Therapy ◽

Hiv Positive ◽

High Grade ◽

Squamous Intraepithelial Lesion ◽

Highly Active ◽

Intraepithelial Lesion

CONTEXT: Highly active antiretroviral therapy (HAART) has turned human immunodeficiency virus (HIV) infection into a chronic condition, and this has led to increased incidence of anal dysplasia among HIV-positive patients. Routine anal evaluation including the anal canal and perianal area is recommended for this population, especially for patients infected by oncogenic human papillomavirus (HPV) types. CASE REPORT: A 54-year-old homosexual HIV-positive man presented with a six-year history of recurrent perianal and anal warts. He had previously undergone incomplete surgical excision and fulguration in another institution on two occasions. He had been using HAART over the past two years. He presented some condylomatous spreading lesions occupying part of the anal canal and the perianal skin, and also a well-demarcated slightly painful perianal plaque of dimensions 1.0 x 1.0 cm. Both anal canal Pap smears and biopsies guided by high-resolution anoscopy revealed high-grade squamous intraepithelial lesion. Biopsies of the border of the perianal plaque also revealed high-grade squamous intraepithelial lesion. HPV DNA testing of the anus detected the presence of HPV-16 type. The patient underwent local full-thickness excision of the lesion. Histological analysis on the excised tissue revealed high-grade squamous intraepithelial lesion with one focus of microinvasive squamous cell cancer measuring 1 mm. No lymph vessel or perineural invasion was detected. The patient showed pathological evidence of recurrent anal and perianal high-grade squamous intraepithelial lesions at the sixth-month follow-up and required further ablation of those lesions. However no invasive squamous cell carcinoma recurrence has been detected so far.

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Oral squamous cell carcinoma in human immunodeficiency virus positive patients: clinicopathological audit

The Journal of Laryngology & Otology ◽

10.1017/s0022215111002647 ◽

2011 ◽

Vol 126 (3) ◽

pp. 276-278 ◽

Cited By ~ 6

Author(s):

F M A Butt ◽

M L Chindia ◽

F Rana

Keyword(s):

Human Immunodeficiency Virus ◽

Squamous Cell Carcinoma ◽

Oral Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Highly Active Antiretroviral Therapy ◽

Histopathological Classification ◽

Highly Active ◽

Increased Risk ◽

Immunodeficiency Virus

AbstractBackground:Most human immunodeficiency virus positive patients now have a longer life expectancy, with the advent of highly active antiretroviral therapy. However, they are now at increased risk of developing a malignancy during their lives.Aim:To investigate the age at which oral squamous cell carcinoma presents in patients infected with human immunodeficiency virus.Study design:Prospective, clinicohistopathological audit of patients infected with human immunodeficiency virus.Results:Of 200 human immunodeficiency virus positive patients, 16 (8 per cent) presented with oral squamous cell carcinoma (nine women and seven men; age range 18–43 years, mean age 31.7 years). The majority of patients (62.5 per cent) had stage III and IV disease (tumour-node-metastasis staging). There was a predilection for poorly differentiated oral squamous cell carcinoma (using Broder's histopathological classification).Conclusion:Oral squamous cell carcinoma associated with human immunodeficiency virus infection appears to present at a relatively young age.

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Non-AIDS Defining Malignancies Become an Emerging Problem in HIV-Infected Patients

10.31219/osf.io/9br84 ◽

2016 ◽

Author(s):

Khin Soe ◽

Zaw Moe Thein

Keyword(s):

Squamous Cell Carcinoma ◽

Retrospective Study ◽

Antiretroviral Therapy ◽

Oral Squamous Cell Carcinoma ◽

Hiv Infection ◽

Cell Carcinoma ◽

Highly Active Antiretroviral Therapy ◽

Oral Pathology ◽

Highly Active ◽

Screening Procedures

The introduction of HAART (Highly Active Antiretroviral Therapy) caused significant decrease in the incidence of AIDS-defining illnesses among individuals undergoing antiretroviral therapy. In the resent years, the research observed a worrying increase in the incidence of non-AIDS-defining illnesses and increases mortality related to these cases. In this retrospective study, we observed surgical pathology cases with HIV infection those sent to Oral Pathology Unit, University of Dental Medicine, Yangon, from January 2013 to November 2015. Twelve cases were analyzed in relation with their request forms and biopsy results. In general, there were noticeably larger numbers of non-AIDS-defining malignancies (for instance, oral squamous cell carcinoma). According to this study, non-AIDS-defining malignancy is found to be an emerging problem in HIV-infected patients. Further epidemiological and clinico-pathological studies as well as screening procedures should be warranted to solve this problem.

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