Ocular Malignancies in HIV/AIDS Patients in a Tertiary Health Facility, in Benue State, Nigeria.

Abstract

The severe effect of the HIV pandemic has considerably changed the incidence and prevalence of certain ocular malignancies in many countries in Sub-Saharan Africa (SSA). The tumors are often aggressive, occur in relatively younger age and tend to have unfavorable prognosis. This article discusses the various malignancies affecting HIV/AIDS .patients in a hyper endemic state in Nigeria and compares the modalities of treatment with those of other countries in SSA. A retrospective study of 3168 diagnosed HIV/AIDS patients were carried out from 1st June 2002 to 31st May, 2007. The biodata, ocular presentation, histopathological diagnosis of ocular malignancies and the CD4 count on diagnosis were extracted from the register and Statistical Package for Social Sciences (SPSS) software package was used for data analysis. Of the 3168 cases reviewed, 1826 (57.7%) were males while 1342 (42.3%) were females. The predominant age group was 31-40 years. 125 (4.0%) had ocular malignancies. Of the total malignancies recorded, ocular surface squamous neoplasia (OSSN) constituted the most prevalent (70.0%), followed by Kaposi sarcoma (26.0%) and lymphoma (4%). The most common site of affectation was the limbus (44.8 %). Four out of six (66.7%) cases of invasive squamous cell carcinoma had enucleation, 2 (33.3%) had exenteration, while 46 out of 61 cases (75.45%) of the mild dysplasia form of OSSN had wide excision and had no recurrence. 15 (24.6%) had recurrence and had repeat surgery with adjunct therapy with 5 fluorouracil treatment. Out of the 20 cases of the carcinoma in situ form of OSSN that had wide margin excisional biopsy, there were 2(10%) recurrences that progressed to invasive squamous cell carcinoma. OSSN is the most common ocular malignancy seen among HIV/AIDS patients in Benue State and majority of the patients had wide excision and had no recurrence.

Keywords: Ocular Malignancy, HIV/AIDS, Benue, Nigeria.