Clinical Features And Outcomes Of HIV-infected Women With Cervical Cancer At Federal Teaching Hospital, Gombe, Nigeria

Background: Cervical cancer is an AIDS-defining malignancy and the second commonest cancer in Nigeria. The burden of cervical cancer is higher among HIV-infected women compared to HIV negative women. Objectives: The aim of the study is to describe the characteristics and outcome of treatment of HIV-infected women with cervical cancer. To our knowledge, this is the first report on their survival outcomes and associated predictors after oncology care from north-eastern Nigeria. Methodology: This was a retrospective study with a prospective follow-up of HIV-infected women with cervical cancer attended at Federal Teaching Hospital Gombe, between March 2013 to March 2017. Data extraction form was used to record data on demographic and disease characteristics, treatment received and 24-months follow-up. Analysis was done using descriptive statistics, Kaplan Meier survival and Cox regression methods. Results: Thirty-one patients were attended to during the study period, their mean age was 41.1 years (range, 31-53). The median CD4+ cells count before commencing treatment was 273 cells/mm3 (range, 100 –564 cells/mm3). Seventeen patients 17/31 (54.8%) had poor WHO performance status – grade 3-4, and 23/31 (74.2%) patients presented with advanced-stage disease 2B and above. All the patients were on Antiretroviral therapy (ART), none had surgical excision of the tumour or hysterectomy. The patients had either radiotherapy and/or chemotherapy, or no treatment. The 1-year and 2-year overall survival rates were 35.5% and 22.6% respectively. CD4 count and tumour response were associated with survival [Log-rank X2 = 9.149; p-value = 0.002] and [Log-rank X2 = 5.955; p-value = 0.015] respectively. And low CD4 counts was a determinant of survival [HR=3.8; 95%CI=1.443-10.176]. Conclusion: Most of our patients presented with advanced disease and poor performance status, as such they had poor response to treatment and survival rates. Therefore, cervical cancer screening and treatment should be integrated into HIV programmes to encourage early detection and treatment.