Mycobacterium tuberculosis infection and cytogenetic abnormalities among people with HIV.

OBJECTIVE: To compare cytogenetic abnormalities among people living with HIV (PLWH) with and without previous exposure to Mycobacterium tuberculosis (Mtb) (both latent tuberculosis infection [LTBI] and active tuberculosis [TB]). METHODS: Adult PLWH (≥18 years) were randomly selected at three HIV clinics in Uganda. Previous active TB was confirmed in the clinics' TB records. LTBI was defined as a positive QuantiFERON-TB Gold Plus assay. Participants' buccal mucosal exfoliated cells were examined (per 2000 cells) using the buccal micronucleus assay for chromosomal aberrations (micronuclei and/or nuclear buds), cytokinetic defects (binucleated cells), proliferative potential (normal differentiated cells and basal cell frequency) and/or cell death (condensed chromatin, karyorrhexis, pyknotic and karyolytic cells). RESULTS: Among 97 PLWH, 42 (43.3%) had exposure to Mtb;16 had previous successfully treated active TB and 26 had LTBI. PLWH with exposure to Mtb had a higher median number of normal differentiated cells (1806.5 [1757.0 - 1842.0] vs. 1784.0 [1732.0 - 1843.0], p = 0.031) and fewer karyorrhectic cells (12.0 [9.0 - 29.0] vs. 18.0 [11.0 - 30.0], p = 0.048) than those without. PLWH with LTBI had fewer karyorrhectic cells than those without (11.5 [8.0 - 29.0] vs. 18.0 [11 - 30], p = 0.006). CONCLUSION: We hypothesized that previous exposure to Mtb is associated with cytogenetic damage among PLWH. We found that exposure to Mtb is associated with more normal differentiated cells and less frequent karyorrhexis (a feature of apoptosis). It is unclear whether this increases the propensity for tumorigenesis.

Prognostic Factors for Overall Survival of Patients with Prostate Cancer in Kyadondo County, Uganda.

BACKGROUND: Prostate cancer is the second most common cancer among men globally. A few studies that have been done in Uganda on survival of patients with prostate cancer indicate that, the overall survival of patients with prostate cancer in Uganda is poor. The aim of this study was to determine the 3-year overall survival rate of a cohort of patients with prostate cancer residing in Kyadondo County who were diagnosed from 2012 to 2014. The secondary objective was to correlate the overall survival with the clinicopathological prognostic factors. MATERIALS AND METHODS: This was a retrospective cohort study which involved 136 patients who were diagnosed histologically with prostate cancer at the department of pathology between 2012 and 2014. The cases were registered at the Kampala cancer registry and followed up to 31st December 2017. Data analysis was done using STATA version 12.0. The Kaplan-Meir curves were used for analysis of the 3-year overall survival rate. Hazard ratio (HR) and Log-rank test at 95% confidence interval under Cox-regression model were used to evaluate the effect of the covariates on the 3-year overall survival rate. p < 0.05 was considered statistically significant. RESULTS: More than half of the cases, 55.9% (n = 76) had Gleason score >8. Most of the patients, 67.7% (n = 92) had advanced disease at diagnosis. The 3-year overall survival rate was 67.6% with median survival of 36.5 months and range of 0-65 months. Clinical stage of the patients (HR = 1.65, p = 0.039), Gleason score (HR = 1.88, p = 0.008), and lymphovascular invasion (HR = 0.37, p = 0.002) were the independent predictors of the 3-year overall survival rate in this study. Conclusion. The 3-year overall survival of prostate cancer patients in Uganda is poor. Most of the patients with are diagnosed with advanced clinical stages (stage III and IV). The Gleason score, clinical stage and lymphovascular invasion can powerfully predict independently the overall survival of patients with prostate cancer. This implies that the Gleason score, clinical stage and lymphovascular invasion may be used to predict the overall survival of patients with prostate cancer even prior prostatectomy.