Conjunctival squamous-cell carcinoma associated with HIV infection in Kampala, Uganda

The incidence of conjunctival squamous-cell carcinoma in Kampala, Uganda, was steady at around 6 per million per year from 1970 until 1988, but has increased six-fold since then to 35 per million per year in 1992. Among 48 patients with conjunctival tumours seen at the ophthalmology clinic of the New Mulago Hospital from 1990 to 1991, 75% were HIV seropositive, compared with a 19% seropositivity rate among 48 matched controls (relative risk 13.0, 95% CI 4.5-39.4, p < 0.0001). The recent epidemic of conjunctival tumours in Uganda (and in neighbouring countries) appears to be largely due to the epidemic of HIV infection. Other factors that may contribute to the high incidence of these tumours in equatorial Africa may be exposure to ultraviolet light and conjunctival papillomavirus infection.