People living with HIV (PWH) may have an increased burden of penile cancer. We aimed to evaluate the risk of penile cancer in PWH compared to that of the general population.
We conducted a nationwide retrospective matched cohort study of penile cancer incidence among veterans living with HIV (VWH) compared to veterans without HIV.
We compared penile cancer incidence rates in 44,173 VWH to those of veterans without Human Immunodeficiency virus (HIV) (N = 159,443; 4:1 matched in age. We used Cox regression models to estimate Hazard ratios (HRs) and 95% confidence intervals (CIs) for associations with HIV infection and for penile cancer risk factors.
HIV positivity was associated with an increased risk of penile cancer, with adjusted hazard ratios (HR) of 2.63 (95% CI: 1.64-4.23) when adjusting for age, race/ethnicity, baseline BMI, smoking and alcohol use, economic means test, and history of condyloma. The risk increased to HR = 4.25 (95% CI: 2.75-6.57) when adjusting for all factors except history of condyloma. Risk factors for penile cancer in VWH included lower nadir CD4 count, <50% of follow-up time with undetectable HIV viral load, and history of condyloma.
VWH--particularly those with low CD4 counts, detectable HIV viral loads, or history of condyloma--are at increased risk of penile cancer, suggesting the penile cancer prevention activities are needed in this population.
AIDS (London, England). 2024 Apr 23 [Epub ahead of print]
Jing Zhao, Yongquan Dong, Eva Clark, Jose M Garcia, Donna L White, Jennifer R Kramer, Angela L Mazul, Christine Hartman, Elizabeth Y Chiao
Department of Medicine, Section of Epidemiology and Population Sciences, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas, USA., Health Services Research, Michael E. DeBakey Center for Innovations in Quality, Effectiveness, and Safety (IQuESt), Houston, Texas, USA., Geriatric Research, Education and Clinical Center (GRECC), VA Puget Sound Health Care System, and Department of Medicine, Division of Gerontology & Geriatric Medicine, University of Washington School of Medicine, Seattle, Washington, USA., Department of Otolaryngology-Head and Neck Surgery, Washington University, St. Louis, Missouri, USA., Department of Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas USA.