Human immunodeficiency virus seroprevalence in patients with invasive cervical cancer in Zaria, North-Western Nigeria

Abstract

Background:Cervical cancer is the commonest gynecological malignancy in our environment and is an Acquired Immuno-Deficiency Syndrome (AIDS)-associated malignancy. Documented data on the Human Immune-deficiency Virus (HIV) seroprevalence among patients with cervical cancer in our environment are scarce.Objective:The aim of this study is to determine the prevalence of HIV infection in women with cancer of the cervix.Study Design:The work is a descriptive survey by design, concentrating in frequency of occurrences of prevalence of the dissease in either cases for a number of years retrospectively carried out at the Radiotherapy and Oncology Centre of Ahmadu Bello University Teaching Hospital (ABUTH) Zaria.Setting:The study was carried out at the Radiotherapy and Oncology Centre of ABUTH, Zaria.Materials and Methods:A 5 years retrospective review of patients with histologically-proven cancer of the cervix seen in the Radiotherapy and Oncology Centre, ABUTH, Zaria, North-Western Nigeria was undertaken. Data such as age, clinical stage of disease and HIV seropositivity at presentation were retrieved from the case files. Data analysis was done using the SPSS statistical package version IBM 23 and results presented in frequencies and percentages and charts for graphical presentation.Results:A total of 1,639 patients seen over a period of 5 years were reviewed. The age range of both groups of patients was from 28 years to 92 years with a mean age of 50.5 years. One thousand five hundred and seventy-three of the patients (96%) were seronegative to the HIV tests while 66 (4%) were seropositive. The age range of the seropositive patients was 28 - 49 years with a mean age of 38.1 years. Their peak age at presentation was 30 - 39 years. Similarly, the age range of the seronegative patients was 30 – 92 years with a peak at 40-49 years. 51 (89.5%) of the HIV seropositive patients presented with advanced clinical stage disease, i.e, International Federation of Obstetrics and Gynecology (FIGO) stage 2B and above. 1,363 (93%) of the HIV seronegative patients presented with FIGO 2B disease and above, both scenario illustrating the general trend of late presentation of cancer patients to hospital in our environment.Conclusion:The study shows that the prevalence of HIV infection among cervical cancer patients is low in Zaria, with earlier age of development of cervical cancer among HIV seropositive patients compared to HIV seronegative counterparts. Both group of patients present with cervical cancer at an advanced stage. More studies therefore needed to be done to identify the predisposing factors to the high incidence of invasive cervical cancer in our environment and introduction of cervical cancer screening at an earlier age among HIV seropositive patients.

HIV prevalence in patients with cervical carcinoma

“…[17] A number of studies reported that HIV-positive patients present with cervical cancer at a younger age compared to HIVnegative patients. [9][10][11][12][13][14][15][16] In this study, the HIV infection was further analyzed per age group and data showed that women 40 years old and younger had the highest HIV prevalence of 91.3% followed by 52.4% in the age group 41 to 60 and only 5.3% in the age group 61 and older, confirming reports by others.…”

“…The HIV infection prevalence among the newly diagnosed women with cervical cancer was 52.4% (44/84). The high HIV infection prevalence in this cohort of women within the Free State Province in South Africa is in contrast to a much lower HIV prevalence reported by a number of other studies conducted in South Africa including studies from other African countries, [9][10][11][12][13][14][15][16] see Table 3. Lomalisa et al found a HIV prevalence of 7.2% in women who presented with cervical cancer during Jan 1997 to June 1998 in Gauteng Province.…”

“…[ 14 ] More recently (2018) a study was undertaken in BUTH, Zaria, North-Western Nigeria using data retrieved from case files and reported a 4% HIV seropositivity among patients with cervical cancer. [ 15 ] Also in 2018, Simonds et al in Western Cape Province of South Africa reported in their study a HIV infection prevalence rate of 14.4% among patients with cervical cancer. [ 16 ] Different background of HIV prevalence rates may account for the differences, as shown by 3 South African studies from sites with different HIV prevalence rates.…”

“…Newton et al in 2001 reported a 32% HIV prevalence among cervical cancer patients in Uganda [13] and in 2007 Sekirime and Gray reported a HIV prevalence of 18% from case records reviewed between 1993 and 1995 [14] . More recently (2018) a study was undertaken in BUTH, Zaria, North-Western Nigeria using data retrieved from case files and reported a 4% HIV seropositivity among patients with cervical cancer [15] . Also in 2018, Simonds et al in Western Cape Province of South Africa reported in their study a HIV infection prevalence rate of 14.4% among patients with cervical cancer [16] .…”