Impact of human immunodeficiency virus status on laryngeal cancer survival and locoregional control

Objectives: To compare long-term outcomes of laryngeal cancer (LC) in people living with HIV (PLWH) versus uninfected individuals and determine how clinical and viral factors—such as demographics, cancer stage, HIV viral load, and CD4 nadir—contribute to these outcomes. Methods: This was a retrospective case–control study of 749 patients seen for LC at a single tertiary care center between 2003 and 2017. Of these, 22 had HIV at the time of LC diagnosis, and they were matched in a 1:4 ratio to uninfected controls based on sex, presence of smoking history, and age at cancer diagnosis. Kaplan–Meier survival curves and Cox proportional hazards models were constructed to identify overall and disease-free survival differences based on HIV status, as well as other clinical and viral factors. Results: Compared to all uninfected individuals, PLWH were diagnosed with LC approximately 6 years younger (p =.013). 1-, 2-, and 5-year overall survival for PLWH were 86.4% (63.4%–95.4%), 77.3% (53.7%–89.9%), and 65.8% (40.8%–82.2%), respectively following LC diagnosis, and HIV was not significantly associated with overall (HR = 3.34 [0.59–18.79]) or disease-free survival (HR = 2.12 [0.71–6.36]). The incidence rate of locoregional recurrence among PLWH was 541 compared to 371 per 10,000 person-years in controls, which were not significantly different (p =.420). Furthermore, among PLWH, peak viral load and CD4 nadir were not associated with overall or disease-free survival. Conclusion: While previous work has shown that HIV is associated with elevated risk of LC, survival did not differ significantly between PLWH and uninfected individuals in this study. Level of evidence: 3.