Prevalence of human immunodeficiency virus seropositivity in head and neck malignancies in sub-Saharan Africa.

CONCLUSION

Salivary gland diseases should be handled with a high index of suspicion. Although an inference could be drawn it is not clear from this study if primary head and neck cancers (HNCs) have a significant association with HIV/AIDS.

OBJECTIVE

HIV/AIDS manifestations and malignancies do occur in the head and neck region. The head and neck surgeon is thus involved in the early identification and management of this group of patients. This study evaluated the prevalence of HIV seropositivity in head and neck malignancies (HNMs) in our centre.

MATERIALS AND METHODS

This was a 10 year (January 1996-June 2006) study of all consecutive cases of histologically confirmed HNMs seen in the ENT department of our centre. Participants had HIV screening by ELISA; those with reactive results had a further confirmatory test (mainly Western blot). Pre-test counselling preceded informed consent of each participant. Seropositive participants had post test counselling. All had surgical biopsy for histology.

RESULTS

A total of 521 HNCs (6.6%) were seen in 7941 otolaryngologic consultations within the study period. Males constituted 67.4% and females 32.6% (M:F ratio 2.1:1). Their mean age was 22.1+/-13.7 years (age range 8-85 years). HNCs were most common in the sixth decade. Ten participants (six males and four females) of the study population were HIV seropositive - a prevalence of 1.9% with 70% being in the 17-45 years age group. Laryngeal cancer (n=163, 31.3%) was the most common HNC. Four (36.4%) of the 11 cases of malignant salivary gland cancers (all parotid) were HIV seropositive. More cases of HIV seropositivity were observed during the HNC peak period of 2004-2006.