Abstract
Increased availability of highly active anti-retroviral therapy (HAART) has led to a change in the spectrum of neoplastic diseases affecting people living with HIV. Some cancers such as invasive cervical carcinoma and anal cancers have not changed or instead risen while others such as Kaporsi's sarcoma have seen a sharp decline. The aim of this study was to compare clinical findings at presentation between HIV positive and Negative patients with head and neck cancers using a retrospective case control design. The study was done at the Uganda cancer Institute by performing a manual match of records in the head and neck cancer database at a ratio of 1:2 cases: controls. The matching was done on the age group, gender and diagnosis. Clinical and demographic characteristics between HIV positive and HIV negative head and neck cancer patients were compared using chi square and a multinomial model including ECOG performance score, stage, grade and duration group was run. In the multinomial regression only duration group was significant with the HIV positive patients being more likely to present after a longer duration of the symptoms than HIV negative patients (OR=0.42 CI 0.20-0.86 p=0.02). The data does not show statistically significant difference between HIV positive and HIV negative head and neck cancer patients in terms of presentation at time of diagnosis except for duration of symptoms group. This study clearly demonstrates the need for more research on head and neck cancer in Africa in the context of HIV/AIDS, since the reasons for the high HIV prevalence among this cohort of patients hasn't been established.
Highlights
Since the time HIV/AIDS, was recognized by the medical fraternity, a number of other disease entities have been associated with the syndrome
On the other hand neoplastic diseases such as Sarcoma of Kaposi (KS) and primary central nervous system non-Hodgkin’s lymphomas (PCNLs) are considered as illness defining while other NHLs such as Burkitt’s (BL), diffuse large B cell (DLBCL) and primary effusion lymphomas (PEL) have an increased incidence among HIV+ve people
Every Tuesday the head and neck tumor board sits to discuss all new fully staged patients referred to the institute with a head and neck cancer diagnosis except for lymphomas that are sent to the lymphoma treatment center (LTC) of the same institute
Summary
Since the time HIV/AIDS, was recognized by the medical fraternity, a number of other disease entities have been associated with the syndrome. With the increased availability of highly active anti-retroviral therapy (HAART) the spectrum of neoplastic diseases affecting people living with HIV has changed tremendously with a sharp decline in KS, DLBCL, PEL and epidemic associated BL. Though some such as invasive cervical carcinoma and anal cancers have not changed or have instead risen [3]. In Uganda HIV/AIDS associated malignancies such as KS, NHL and invasive SCCA of the cervix have been shown to rise but the Kamulegeya Adriane and Otiti Jeff: Head and Neck Cancers Case Control Study of HIV Positive Compared to Negative
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