Head and neck lesions among HIV/AIDS patients on highly active antiretroviral therapy attending the Muhimbili National Hospital in Dar es Salaam, Tanzania

Athanase Masele, Karpal Singh Sohal, Boniphace M. Kalyanyama, Sira Stanslaus Owibingire, Elison N. M. Simon

Abstract

Background: Head and neck (H&N) lesions in HIV/AIDS can involve the skin and upper aero-digestive tract, therefore, they may not only indicate HIV infection but also may be among the early clinical features and can predict the progression of HIV disease to AIDS. However, with introduction highly active antiretroviral therapy (HAART) there has been a global reduction in H&N lesions. This study aimed to determine the incidence of H&N lesions among HIV/AIDS patients on HAART attending the Muhimbili National Hospital (MNH).
Methods: This was a cross-sectional hospital-based study which was carried at the HIV clinic of the MNH in 2015/2016. Through convenient sampling technique, 346 patients were recruited in the study. A pre-designed questionnaire was used to obtain socio-demographic data and duration since when the patients were diagnosed with HIV/AIDS. Physical examination and laboratory investigations (histology and CD4 counts) were conducted. Data obtained were analyzed using Statistical Package for Social Sciences program version 23.
Results: Of the total number of patients included in the study, 55 (15.9%) had H&N lesions. There were more females (78.2%) with the male to female ratio of 1:3.6. Mean age of the patients was 38.27±1.74 years. About 36.4% (n=20) of the patients with H&N lesions were diagnosed with HIV/AIDS within 2 years. The majority had CD4 counts of ≤200 cells/μL. Oral candidiasis, head and neck squamous cell carcinoma (HNSCC), Kaposi’s sarcoma (KS) and non-Hodgkin’s lymphoma (NHL) were the common lesions encountered.
Conclusions: The incidence of H&N lesions in patients with HIV/AIDS on HAART was low. Oral candidiasis was the most common infection and HNSCC was the leading malignant H&N lesion in this group of patients. Most of the patients with H&N lesions had CD4 levels <200 cells/μL.