Ocular Surface Squamous Neoplasia as the First and Only Apparent Manifestation of Hiv Infection in an Urban Patient Population in Southeast Africa

Abstract

Purpose: : To evaluate the prevalence of undiagnosed and asymptomatic HIV infection in patients with ocular surface squamous neoplasia (OSSN) in an urban patient population in sub-Saharan Africa.

Methods: : A consecutive series of patients presenting with OSSN was evaluated in an African academic center. A detailed history and physical examination in 53 consecutive patients with conjunctival squamous cell carcinoma (SCC) and conjunctival intra-epithelial neoplasia (CIN) was performed. 38 (72%) patients agreed to undergo serological HIV testing

Results: : 79% (30 of 38) of all tested patients were HIV positive. None of the patients had previous HIV testing or was aware of having symptoms of HIV. 70% (n=21) of the HIV positive patients had no other symptoms suggestive of HIV infection or any other disease althoughmany patients recalled that the ocular tumor has been present for more than 6 to 12 months. Patients were far more likely to refuse HIV testing if they were married.

Keywords: AIDS/HIV • tumors • oncology