Epidemic (human immunodeficiency virus-related) Kaposi's sarcoma in West African women

Antibiotic sensitivity profile of Staphylococcus aureus isolated from HIV/AIDS patients presenting with pyoderma, at the Yaounde Central Hospital, Cameroon

Introduction

the purpose of this study was to evaluate the in vitro activity of several antibiotics against strains of Staphylococcus aureus isolated from pyoderma in people living with Human Immunodeficiency Virus (HIV), consulting at the day clinic of the Yaoundé Central Hospital.

Methods

this was a prospective, cross-sectional study which was carried out in five months (November 2013-March 2014). Fifty-three (53) pus specimens were collected; from which the isolation of Staphylococcus aureus was made using Chapman agar. Mannitol fermentation, catalase, coagulase and DNase tests were used for species identification. Antibiotic sensitivity of each strain was determined by the agar diffusion method.

Results

forty-eight (48) strains of Staphylococcus aureus were isolated (90.56%). A high rate of sensitivity to antibiotics was observed in many strains: vancomycin (100.0%), pristinamycin (100.0%), chloramphenicol (100.0%), oxacillin (97.9%), cefoxitin (97.9%), gentamicin (87.5%), tobramycin (83.3%). However, some strains had strong resistance to penicillin G (89.6%) and cotrimoxazole (64.6%). The proportion of Methicilin Resistant strains of Staphylococcus aureus (MRSA) was low (2.0%). The kanamycin-tobramycin-gentamycin phenotype (KTG) was most common in the aminoglycosides resistant strains; the same as the induced phenotype E stains (iMLSB) in macrolides resistant strains. Conclusion: these results indicate that many of these antibiotics tested are still effective against strains of Staphylococcus aureus.

Human Herpesvirus 8 Infections and AIDS-Associated Kaposi Sarcoma in Zaria, Northern Nigeria

BACKGROUND/OBJECTIVES

Studies on human herpesvirus 8 (HHV8) infection in patients with AIDS-associated Kaposi sarcoma (AIDS-KS), from Nigeria are lacking. We examined the seroprevalence of HHV8 infection in patients with AIDS-KS presenting to Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, Nigeria, and also described their clinical presentation.

METHODS

A total of 20 (11 males and 9 females) histologically confirmed adults with AIDS-KS were recruited consecutively in 2007. The clinical types of lesions, associated diseases, and the AIDS clinical trial group staging of AIDS-KS were noted. Anti-lytic HHV8 antibodies were determined by enzyme-linked immunosorbent assay (ELISA).

RESULTS

Kaposi sarcoma skin lesions were diverse but mostly nodules (19 cases) and papules (16). Majority (18 cases) had poor risk AIDS-KS, with 10 (50%) patients having concomitant opportunistic infections and 3 (15%) patients having generalized skin lesions. Females had a more severe disease. Seventeen patients (85%) were HHV8-seropositive.

CONCLUSION

AIDS-KS is associated with high HHV8 infection and presents with a variety of skin manifestations that are often aggressive, advanced, and worse in females.

Presentation and survival of patients with AIDS-related Kaposi's sarcoma in Jos, Nigeria

AIDS-related Kaposi's sarcoma (AIDS-KS) remains a significant cause of morbidity and mortality. We describe the pattern of presentation and survival in Jos, Nigeria. We identified 48 HIV-positive patients with AIDS-KS and matched them for age and sex with an equal number of HIV-positive patients without AIDS-KS. We compared their clinical, immunological, virological characteristics and survival. They were similar in age and body mass index profile but patients with AIDS-KS had more tuberculosis co-infection (P, 0.02), lower median CD4 count (P, 0.003) and higher mortality (P, 0.002). Surprisingly, patients with AIDS-KS had lower levels of median viral load (29,347 copies/mL) compared with controls (80,533 copies/mL). We recommend specific AIDS-KS therapy in addition to highly active antiretroviral therapy in order to improve survival.

Kaposi sarcoma: a continuing conundrum

Kaposi sarcoma (KS) remains a challenge. Its classic or Mediterranean form tends to be benign. In transplant recipients it may be less so. As part of the AIDS pandemic, of which it was an original defining component, it may be life-threatening. It is due to human herpesvirus-8, which is necessary but not sufficient to produce the disease. KS has a low prevalence in the general population of the United States and United Kingdom, with an intermediate rate in Italy and Greece, and a high one in parts of Africa. In Italy, hot spots include its southern regions, the Po River Valley, and Sardinia, possibly related to a high density of blood-sucking insects. An important challenge is to treat KS patients without immunocompromising them. The potential of effective anti-herpes virus therapy and the use of sirolimus in transplantation recipients have added new opportunities for KS prevention.

LEARNING OBJECTIVES

At the conclusion of this learning activity, participants should be able to provide the most recent information about Kaposi sarcoma in the context in which it occurs. Its classic or Mediterranean form, its pattern in transplant recipients and others iatrogenically immunosuppressed, and its occurrence as a potentially life-threatening part of the AIDS pandemic will be stressed. Its etiology and transmission will be discussed in detail to facilitate understanding of Kaposi sarcoma and of human herpesvirus-8 infection in the general population of the United States and United Kingdom, in Italy and Greece, and in certain parts of Africa. Its therapy, including the concept of doing it without immunocompromising the patient, will be stressed. New opportunities for Kaposi sarcoma prevention will also be discussed.

Kaposi's sarcoma in Nigeria

BACKGROUND

The prevalence of Kaposi's sarcoma (KS) in parts of Africa has been on the increase as a result of the human immunodeficiency virus (HIV) infection pandemic. However, there is a paucity of information for Nigeria.

OBJECTIVE

To describe the clinical and epidemiological characteristics of cutaneous KS in patients with HIV-infection in Benin City, Nigeria.

METHODS

All patients presenting to the dermatology and infectious diseases clinics of the University of Benin Teaching Hospital, or admitted to its medical wards, within the period July 2000-June 2005 were examined retrospectively in a chart review for KS. Diagnosis of HIV was based upon ELISA testing. The CD4(+) cell counts were performed using the Dyna Bead method and KS was diagnosed histologically.

RESULTS

In our survey, 31 patients, representing 0.84% of all new HIV patients seen during the study period, had cutaneous KS. There were 19 males and 12 females, giving a male to female ratio of 1.6 : 1. The mean age was 36.3 +/- 9 years; mean CD4(+) count was 127 +/- 14 cells/dl. The lower limbs (74.2%), trunk (48.4%) and the face (22.6%) were the most frequent sites affected. The lesions were solitary in three patients (9.7%) and multiple in 28 patients (90.3%).

CONCLUSION

The prevalence of HIV-related KS is increasing in Nigeria. There is an increase in the number of women being diagnosed with this form of KS, probably owing to more females having HIV disease.