Abstract 7417: Biological, clinical and epidemiological risk factors for oropharyngeal cancers in people with HIV in Puerto Rico

Abstract Background: People with HIV (PWH) are at a higher risk of developing cancers. Periodontal disease (PD), which is highly prevalent in PWH, is a chronic inflammatory disease associated with increased risk factor for oropharyngeal cancers as well as lung, pancreatic and colorectal cancers. Dysbiosis of the oral microbiome and oral human papillomavirus (HPV) infection can increase cancer risk. Puerto Rico (PR) has disparities in HIV infection and HPV-related malignancies, and socio-economic disadvantages that further increase cancer risk, but none of these risk factors have been evaluated altogether in PWH, particularly in PR. In this study, we evaluated the prevalence of PD in Puerto Rican PWH and analyzed other risk factors associated with oropharyngeal cancers in relation to PD. Methods: We collected saliva and oral rinse samples as well as PD status from 165 sexually active and virally suppressed PWH. We also collected sociodemographic, clinical and lifestyle variables through a questionnaire. In a subset of participants, we evaluated HPV infection and genotype (DNA ELISA kit HPV SPF10 and RHA kit HPV SPF10-LiPA2, n=135), the oral bacteriome (16s sequencing, n=98) and oral mycobiome (ITS sequencing, n=32), in relation to PD as factors for increased oral cancer risk. Diversity, taxonomic assignments, differential abundance analysis and statistical analysis were performed using QIIME2 and R-statistical software. Results: High prevalence of PD (86%) was observed, with moderate (60%) and severe (27%) being the most abundant. PWH with PD had significantly lower median CD4 count than PWH without PD (753cells/µl vs. 895cells/µl p=0.029). HPV+ PWH had a 95% prevalence of PD, with the prevalence of severe PD increasing to 35%. Furthermore, PD was also significantly associated with higher bacterial and fungal phylogenetic diversity (p=0.048 and p=0.028, respectively) and higher bacterial richness (p=0.063). In addition, significantly higher abundance of fungal pathogenic species was observed in PD, characterized by higher relative abundance of Candida. Conclusion: Overall, high prevalence of PD significantly associated with lower median of CD4 count was observed in Puerto Rican PWH, which may contribute to a higher risk for oropharyngeal cancers, as well as other distal cancers. Moreover, dysbiosis of the oral microbiome and oral HPV infection associated with PD could contribute to subsequent inflammation and oral tissue damage which can further increase cancer risk. Understanding the mechanistic interplay between these cancer risk factors is essential to establish targets for early prognosis and personalized treatment approaches and better preventive public health strategies to reduce oropharyngeal cancers. Citation Format: Juliana M. Serrano-Rodríguez, Jurelis Torres-Reyes, Yakshi N. Ortiz-Maldonado, Carlos A. Solá-Morlá, Gabriel Borges-Vélez, Jeannette Salgado-Montilla, María M. Sánchez-Vázquez, Magaly Martínez-Ferrer, Ramón F. González-Garcia, Josué Pérez-Santiago. Biological, clinical and epidemiological risk factors for oropharyngeal cancers in people with HIV in Puerto Rico [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 7417.