Cancers of eyelid: Report of two cases

There are four main types of eyelid cancer. Basal Cell Carcinoma that by far the most common (85% of cases). This is a tumour of older person, after 50 years. Its occurrence in a child must search for Basal Cell Hamartoma. Squamous Cell Carcinoma represents about 5% of cases. It can occur de novo or more frequently on precancerous lesions. Acquired immunosuppression, xeroderma pigmentosum and albinism predispose to the occurrence of this cancer. The Sebaceous Carcinoma represents a little less than 5% of cases. The third type may arise in the meibomian, Zeis or sebaceous glands. Its diagnosis is often delayed because of its seemingly benign clinical appearance. Malignant Melanoma is a rare tumour of the eyelids, less than 1% of cases. From two observations, one Basal Cell Carcinoma and one Squamous Cell carcinoma in HIV/AIDS context, we did a short review of the literature on eyelid cancer pathology

Immune Reconstitution Inflammatory Syndrome and Shingles Associated with a Combined Paralysis of Three Oculomotor Nerves: A Case Report

BACKGROUND: In countries with high prevalence of HIV/AIDS infection, particularly in black Africa, shingles is one of the main opportunistic infections during immunosuppression due to AIDS in young patients. If immunological weakness is important, usually when the CD4 cell count is less than 100 cells/mm3, the risk of inflammatory reactions in the first three months after initiating of antiretroviral treatment (ART) is very high. This inflammatory reaction is called immune reconstitution inflammatory syndrome (IRIS). This observation reports the first documented case of IRIS with V1 shingles in a young HIV patient at University Hospital of Brazzaville.CASE DETAILS: A 40 years old patient was seen for a pain of the right side of the face and a complete immobility of the eyeball. The diagnosis of V1 shingles with a pan uveitis, and a paralysis of III, IV and VI nerves was made. The patiants HIV status was positive and CD4 cell count was 150 cells/mm3. After two months of evolution under ART with a CD4 count of 850 cells /mm3, the symptomatology was quickly complicated by significant inflammation causing a phtisis bulbi.CONCLUSION: CD4 cells count is an important indicator in the HIV/AIDS therapy. In some major forms of IRIS, momentary pause of anti retroviral treatment is sometimes necessary.KEYWORDS: AIDS, Immune reconstitution Inflammatory Syndrome, Shingles, Oculomotor Nerves Paralysi

Eruptive syringoma mimicking keloid scars: Case report

The eruptive syringoma represent a rare variant of syringomas. It is a benign tumour derived from eccrine ductal elements. The disease is manifested by papules that arise on the front side of body, usually in young subjects. The eruptive syringoma is asymptomatic, but it may sometimes be pruritic. We report a 25-year-old woman presented with eruptive syringoma resembling keloids scars

Conjunctival cancers in HIV patients at the university hospital of Brazzaville

Background: Conjunctival cancers are masses raised or flat, located in or directly under the conjunctival mucous membrane covering the anterior sclera, tarsus and conjunctival dead-end. These tumours usually occur in the elderly or in cases of HIV/AIDS.Objective: To list the different types of conjunctival cancer in cases of HIV/AIDS at the University Hospital of Brazzaville.Design: It was a descriptive and transversal study, conducted between January 2008 and December 2012.Setting: The University Hospital of Brazzaville.Subjects: HIV patients under anti-retroviral treatment or not seen for conjunctival cancer histologically proven were selected.Results: Twenty-eight patients (28) were selected including a woman at 30 weeks of gestation. Two types of cancers were diagnosed, Carcinoma in situ (28.57%) and Squamous Cell Carcinoma (71.43%), no secondary tumour. There were anti-retroviral treatment failure in 89.29% of the cases.Conclusion: Squamous Cell Carcinoma was the most common conjunctival cancer. Better compliance of anti-retroviral treatment can reduce the prevalence of these tumours

HIV-1 genetic diversity and primary drug resistance mutations before large-scale access to antiretroviral therapy, Republic of Congo

Abstract Background In this work, we investigated the genetic diversity of HIV-1 and the presence of mutations conferring antiretroviral drug resistance in 50 drug-naïve infected persons in the Republic of Congo (RoC). Samples were obtained before large-scale access to HAART in 2002 and 2004. Methods To assess the HIV-1 genetic recombination, the sequencing of the pol gene encoding a protease and partial reverse transcriptase was performed and analyzed with updated references, including newly characterized CRFs. The assessment of drug resistance was conducted according to the WHO protocol. Results Among the 50 samples analyzed for the pol gene, 50% were classified as intersubtype recombinants, charring complex structures inside the pol fragment. Five samples could not be classified (noted U). The most prevalent subtypes were G with 10 isolates and D with 11 isolates. One isolate of A, J, H, CRF05, CRF18 and CRF37 were also found. Two samples (4%) harboring the mutations M230L and Y181C associated with the TAMs M41L and T215Y, respectively, were found. Conclusion This first study in the RoC, based on WHO classification, shows that the threshold of transmitted drug resistance before large-scale access to antiretroviral therapy is 4%

Syphilis and HIV infections among pregnant women attending antenatal clinics in Republic of Congo

Introduction: HIV and syphilis during pregnancy remain a public health concern especially in developing countries. Pregnant women attendingantenatal clinics sites for the first time between September and December 2011 and who accepted to participate in the study were enrolled. Theobjective was to estimate the syphilis and HIV infection rate in this population.Methods: A study was conducted in 44 selected ANCs from 12 departments (5 urban and 7 rural). Pregnant women who accepted to participate in the study, attending selected sentinel ANCs sites for the first time between September and December 2011 were enrolled. To detect HIV antibodies, two consecutive ELISA assays were used (Genscreen Ultra HIV Ag/Ac, (BioRad, France) and Enzygnostic  Intergral II (Siemens, GMBH, Marbug-Germany). In case of discordant results, the Western blot test II, HIV1 and 2 (Bio-Rad, Marne la Coquette, France) was used as the reference method. The RPR (Bio-Scan,  Karnataka, India) test was performed to detect syphilis infection. The RPR positive results were confirmed using the TPHA test (Biotech, Cambridge, UK). Data were analyzed using SPSS 17.0 software.Results: A total of 2979 pregnant women attending ANCs were enrolled. The global HIV infection rate was estimated to be 3.6% (CI: 95%; 3.0-4.4). As expected, HIV prevalence was significantly higher in women aged above 25 years (4.4% (3.4-5.6), p = 0.026) and those attending urban ANCs (5.04%, p < 0.01). Also, women living in the urban area are more at risk to be infected (5.04 VS 2.38, p < 0.01). The RPR test was positive in 117 pregnant women (3.92%). The risk for syphilis occurrence was significantly higher among the single women compared to the married ones (4.4% VS 2.7%; p < 0.01). It was also estimated that the HIV and syphilis coinfection occurred in 22 cases (0.73%).Conclusion: The prevalence's of syphilis and HIV were relatively low. Marital status and sentinel site location were a risk factor associated withHIV and syphilis infections respectively. Therefore, substantial effort is needed to reinforce prevention strategies in this population to preventmother-to-child and further horizontal transmissions of these infections.Key words: HIV, syphilis, pregnant women, Republic of Congo (RoC

A study on HIV, Syphilis, and Hepatitis B and C virus infections among female sex workers in the Republic of Congo

Abstract Background Female Sex Workers (FSWs) are considered to be at high risk for transmission of Sexually Transmitted Infections (STIs) and are defined as a priority of the national HIV/AIDS response in the Republic of Congo (RoC). However, no data are available regarding STIs in this group. This study aimed to determine the prevalences of HIV, syphilis and hepatitis B and C among FSWs in five cities in the country. Methods A cross-sectional study was conducted from November 2nd 2011 to May 15th 2012. Participants were recruited in Brazzaville, Pointe-Noire, Dolisie, Nkayi and Pokola using a respondent-driven sampling method. Results A total of 805 FSWs were recruited with an average age of 28.31 ± 9.15 years. The overall prevalences of HIV, syphilis, HBV and HCV were 7.50%, 2.20%, 4.20% and 0.70%, respectively. The age groups 35–39 (20.51% [0%–36.93%], p = 0.0057) and greater than 40 years (16.67% [0%–34.93%], P = 0.016) were positively associated with behaviors at high risk of HIV infection. For syphilis, the most infected age group was the one greater than 40 years, at 6.25% ([1.06% –72.37%] p = 0.04). Pointe-Noire was the most infected city for syphilis and HBV, with 5.15% (p = 0.0061) and 4.22% (p˂0.001), respectively. No risk factors were associated with HCV infection. FSWs practicing in mobile prostitution sites had a significantly higher infection rate (2.1% [0%–11.09%] p = 0.04). Conclusion This study shows that the prevalence of HIV and other STIs in FSWs is high. Therefore, a combination of individual and structural interventions could reduce the risk of an STI “reservoir” among this population