Human Papilloma Virus in conjuctival Squamous Cell Carcinoma at the University Teaching Hospital and Lusaka Adventist Eye Hospital Zambia

Abstract

Background Human papilloma virus (HPV) has been associated to conjunctival squamous cell carcinoma (CSCC) and has been documented in studies originating from different parts of the world. In Zambia, eye cancers are on the increase and between 2005 and 2009 they were ranked number three (3) among the top five (5) cancers of which conjunctival squamous cell carcinoma (CSCC) (78%) was the commonest. In this study, the aim was to establish the prevalence and association of HPV infection with CSCC at the University Teaching Hospital (UTH) and Lusaka Adventist Eye Hospital, Zambia. Materials and Methods This was a cross section study conducted at UTH and Lusaka Adventist Eye Hospital, Zambia for a period of three (3) months. A convenient sampling method was used. Conjunctival biopsies were collected from patients aged over 20 years with clinically suspected CSCC and met an inclusion criteria making the sample of 37 participants. Histopathology and polymerase chain reaction assay (PCR) analysis of 37 specimens of conjunctival lesions was undertaken. Tissues confirmed as CSCC (21) were grouped as cases and non-CSCC tissues (16) as controls. Findings were analysed using statistical software SPSS for windows version 18.0. Univariate analysis of variables which were CSCC, HPV, and HIV was conducted to determine the distribution patterns of HPV and HIV. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed stratifying by age, sex, human papilloma virus and HIV status. Results This study revealed that, 59.5% of the conjunctival tissues were malignant of which 95.5% were CSCC and 4.5% were Kaposi’s sarcoma. Most of the participants 57% were HIV positive. 71.4% of patients with CSCC were HIV positive and HPV DNA was detected in 71.4% of CSCC tissues. HPV DNA was detected in 52.4% HIV+ patients and in 62.5% HIV- patients. Conclusion The study showed a high prevalence of HPV infection (71.4%) in CSCC. HPV and HIV infections were both associated with conjunctival SCC. Though HPV infection was found in patients with HIV, there were no significant differences in the results between HIV positive and HIV negative patients.