Gynaecological Cancers in HIV Positive and Negative Women—A Single-Center Retrospective Study (2008-2017)

Abstract

Background/Objective: The association between Human Immunodeficiency Virus (HIV) and invasive cervical carcinoma is fully recognized. However, the effect of HIV and antiretroviral therapy on the morbidity and mortality of other gynaecological cancers have not been conclusively determined. Our study objective was to examine the effects of HIV on patient age at presentation, prevalence, and severity of the illness of various gynaecological cancers diagnosed in University of Nigeria Teaching Hospital (UNTH), Enugu over the period 2008-2017. Methods: This was a retrospective cross-sectional study of 224 patients who were managed in UNTH for different gynaecological malignancies. Ethical clearance was obtained from the Research Ethics Committee of the UNTH, Enugu. Data analysis was done with SPSS software with results expressed in descriptive statistics of simple frequency and percentage, and p-value set at Results: A total of 224 patients were studied. Twenty-five percent of HIV positive patients were aged 31 - 40 years at presentation compared to 12% of HIV negative patients. The commonest gynaecological cancer was cervical cancer with a higher proportion among the HIV-positive patients. While 32% of HIV negative patients presented at FIGO stages 1 - 2 Versus 8.3% of HIV positive patients, 58.3% and 33.3% of HIV positive patients presented at stages 3 and 4 respectively. Only 8.3% of HIV positive patients presented with ovarian cancer compared with 31% of HIV negative patients. A higher proportion of HIV positive patients presented with vulvar cancer (16.7%), but no endometrial or choriocarcinoma/GTD, compared with HIV negative patients. Conclusion: HIV positive clients present at an earlier age with more advanced disease, mostly cervical cancer of the squamous cell variety, with minimal non-AIDS defining cancers over the study period in UNTH, Enugu.