Fatal Fast-Evolution of Nasopharyngeal Cancer in an HIV Patient
Author Information
Author(s): Sirera Guillem, Videla Sebastià, Romeu Joan, Cañadas MariPaz, Fernández Maria-Teresa, Balo Susana, Cirauqui Beatriz, Darwich Laila, Frey-Joly Celestino, Clotet Bonaventura
Primary Institution: University Hospital Germans Trias i Pujol, Badalona (Barcelona); Universitat Autònoma de Barcelona (U.A.B.)
Hypothesis
Can the presence of EBV and HPV in an HIV-infected patient lead to rapid progression of nasopharyngeal squamous cell carcinoma?
Conclusion
The case suggests that advanced HIV patients with severe immunodeficiency may experience rapid tumor evolution and detectable viruses in blood, which could be linked to worse outcomes.
Supporting Evidence
- EBV was positive in the biopsy and in serum at 63000 copies/mL.
- HPV was detected in serum for two high risk oncogenic types: HPV-16 and HPV-33.
- HPV was also detected in the anus and penis.
- Patients with HPV-positive tumors have a better overall survival than those with HPV-negative tumors.
- The rapid evolution observed could be mainly related to severe immunodeficiency due to HIV.
- Widespread metastatic lesions suggest the expression of chemokine receptor CXCR4 associated with high metastatic potential.
- Risk factors such as smoking and alcohol consumption could contribute to aggressive clinical outcomes.
Takeaway
This study shows that a man with HIV got a very aggressive type of throat cancer, and the viruses in his blood might have made it worse.
Methodology
The study involved PCR real-time and multiplex PCR kit analysis of biopsy and blood serum samples for EBV and HPV.
Limitations
The serum sample studied could only represent a single time point during the patient’s care.
Participant Demographics
A 38-year-old man diagnosed with HIV, ex-intravenous drug user, smoker, and alcohol consumer.
Digital Object Identifier (DOI)
Want to read the original?
Access the complete publication on the publisher's website