title: Conjunctival squamous cell carcinoma in patients with human immunodeficiency virus infection seen at two hospitals in Kenya.
abstract: OBJECTIVE
  To estimate the prevalence and pattern of conjuctival squamous cell carcinoma (CSCC) in patients with HIV infection.
  
  
  METHODS
  A hospital based cross sectional study.
  
  
  METHODS
  Kenyatta National Hospital (KNH) and Kikuyu Eye Unit (KEU) during the period November 2003 and May 2004.
  
  
  METHODS
  Four hundred and nine HIV positive patients.
  
  
  RESULTS
  Four hundred and nine HIV positive patients aged 25 to 53 years were screened. Male to Female ratio was 1:1. One hundred and three had conjunctival growths. Thirty two had histologically proven conjunctiva squamous cell carcinoma (CSCC). Estimated prevalence of CSCC among HIV positive patients was 7.8%. The average duration of growth of the conjunctival masses was 21.8 months. The average size of the lesions at the time of presentation was 6.6 mm. Twenty two (68.8%) patients had primary CSCC, while ten (31.2%) had recurrent lesions. The pattern of the histopathology results was: fifteen (46.9%) patients had poorly differentiated squamous cell carcinoma; nine (28%) had moderately differentiated squamous cell carcinoma; five patients (15.6%) had CIN; two patients (6.3%) had dysplasia and one patient (3.1%) had a well differentiated squamous cell carcinoma.
  
  
  CONCLUSIONS
  Prevalence of CSCC in HIV/AIDS patients was 7.8%. Patients present late with advanced lesions. Recurrence rates from previous surgery are high. The often uncharacteristic complaints and findings on presentation complicate the clinical diagnosis. Active search for early manifestations of CSCC in HIV / AIDS patients, complete surgical excision and close follow up is necessary. Alternative treatment methods and techniques like the topical use of antimetabolites should be explored further.
authors.affiliation: St Francis Mission Hospital, Provincial Ophthalmologist, Eastern Province, Katete, Zambia.
authors.forename: S K
authors.initials: SK
authors.lastname: Chisi
authors.forename: M K H
authors.initials: MK
authors.lastname: Kollmann
authors.forename: J
authors.initials: J
authors.lastname: Karimurio
mesh_terms: D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000209:etiology; D003230:Conjunctival Neoplasms / Q000453:epidemiology* / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D015995:Prevalence