Prevalence and prognostic impact of HPV, EBV, and HIV in head and neck squamous cell carcinoma in the Brazilian Amazon cohort

BACKGROUND: Squamous cell carcinoma of the head and neck (SCCHN) is the fifth most common cancer in the world. We investigate the general frequency of SCCHN in the Brazilian Amazon to identify the prevalence of HPV, EBV, and HIV among the local population by means of PCR and to examine the evolution and prognosis of patients. METHODS: This study included 190 individuals with SCCHN and was conducted in the outpatient and inpatient units of the Surgical Clinic of the Department of Head and Neck Surgery of a Hospital in the Brazilian Amazon. We performed HPV detection through PCR and sequencing, EBV detection through RNA in situ hybridization (ISH), and HIV detection through RNA amplification. Statistical analysis included survival estimates through the Kaplan‒Meier curve. RESULTS: Most participants were male (77.9%, 95% CI 72.0-83.8), while 22.1% (95% CI 16.2-28.0) were female. The mean age was 62.2 years (± 12.6; 95% CI 60.4-63.9), with a median age of 64.0 years (range: 27.0-89.0; 95% CI 60.4-63.9). EBV was not significantly associated with SCCHN and may have only been a contaminant at the evaluated sites. Individuals with mutations in the TP53 and EGFR genes developed more aggressive cancer phenotypes, leading to a 2.6-fold increase in the risk of death. SCCHN was present in the sample, affecting 3.5 times more men than women, with stage IV being the most frequent. CONCLUSIONS: TP53 and EGFR gene mutations were associated with more aggressive cancer phenotypes, leading to a 2.6-fold increase in the risk of death.