Pattern of head and neck malignant neoplasms in HIV-infected patients managed at the Kenyatta National Hospital
Butt, Fawzia M A
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Background: Infection with HIV is associated with profound immunosuppression and hence those afflicted face a greater risk of developing local or systemic malignant disease, the diagnosis of which is a form of surveillance for the acquired immunodeficiency syndrome (AIDS). The most commonly reported neoplasms of the head and neck region in HIV-infected patients include oral Kaposi'S sarcoma/Kaposi's sarcoma (OKS/KS) and non-Hodgkin's lymphoma (NHL). There is also an increased risk of oral squamous cell carcinoma (SeC). Therfore, the pattern of occurrence of these diseases needs to be established. Objedive: To describe the pattern and spectrum of head and neck malignancy in HIV-infected patients. Setting: Kenyatta National Hospital (KNH). Study Period: From February to June 2006 Subjects: Both in-patients and out-patients on the medical and surgical wards; and clinics at the hospital. Methodology: A descriptive cross-sectional study recruiting HIV-infected patients, above the age of 18 years with both non-neoplastic and neoplastic oral manifestations. Data were collected using a structured questionnaire and clinical examination and biopsy done for histopathology. It was analysed using the statistical package for social sciences (SPSS) soft ware version 12. Descriptive and inferential statistiCS were done using the T -test and X2 -test. Results: Of the 200 participants, 116 (S8%) were males and the rest females with an age range of 18 to 61 years (mean=37yrs). Females were significantly younger (mean=33yrs) than males (mean 37=yrs) (T -test;2.S7;P<0.OS [0.001]). The prevalence of neoplastiC lesions in this study was 270/0, among whom, 37 (68%) patients had OKS/KS followed by 9 (170/0) with SCC, then 7 (130/0) with NHL, and 1 (2%) with Be. There were more females than males presenting with lesions of OKS/KS and sec, compared to NHL. The youngest patient presented with SCC at age 18yrs (mean=35.7), followed by KS at 23 yrs (mean=36.3) and NHL at 33yrs (mean=43.9). Most study participants 193 (96.50/0) were in stage III/IV of the disease and the remaining 7 (3.50/0) in stage II. Conclusion: The pattern determined in this study revealed that a younger age group of patients presented with neoplasms. In this study the most common malignant neoplasms were OKS/KS, SCC and NHL. Most of these malignant lesions became more apparent in the advanced stages of the HIV disease.
University of Nairobi
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