Abstract:AIM: To determine epidemiological, clinical profile and access the impact of HIV in its occurrence in 55 eyes of conjunctival squamous cell carcinoma.
METHODS: A cross sectional study, 55 eyes of 54 patients affected by conjunctival squamous cell carcinoma(CSCs)presented in the Ophthalmology Department of University Hospital of Treichville in Abidjan were included. Data were collected: interrogatories, ophthalmologic examination, histopathologic finding, HIV serology, therapeutic(surgery, chemotherapy), follow-up and prognosis. The statistical analysis was performed using Epi-info version 6.0 and a statistical comparison was performed using the Chi-square test with a significance threshold set at 5%.
RESULTS: The age ranged 7-75y(median age 42.28). A female predominance was observed with a sex-ratio of 0.89. The average consultation period was 18mo, with extremes ranging from 6-60mo. Physically 53% of our eyes(29 eyes)presented a functional loss of the eye. And 42 out of the 54 patients were HIV positive with 28 cases of HIV1 infection, 4 cases of HIV2 infection and 10 cases of HIV1 and 2 co-infection. Lymphocyte typing was performed for 28 out of 42 patients with CD4 cell counts <200/mL in 33% of cases, between 200 and 500 in 19% of cases and 500/mL in 12% of cases. It was noted 42 cases(76%)of invasive differentiated squamous cell carcinoma, and 13 cases(24%)of squamous cell carcinoma in situ. Forty localized tumors underwent tumor resection(73%)associated with a postoperative adjuvant topical chemotherapy in 6 cases. Socioeconomic status showed 39% of patients were economic cally inactive. The average follow up period of our patients was 29mo.
CONCLUSION: HIV infection is a risk factor for the occurrence of conjunctival squamous cell carcinoma especially in sub-Saharan Africa where the fight against the infection although boosted in these recent years is far from achieving all objectives. The poor prognosis of conjunctival squamous cell carcinoma reflects the low socioeconomic status of patients, the inadequate medical care in our facilities, the prohibitive cost of anticancer drugs and the link between this disease and HIV/AIDS.