Three cases of classic Kaposi's sarcoma with different subtypes of Kaposi's sarcoma-associated herpesvirus

Oral Kaposi Sarcoma in HIV-seronegative Saudi patient: Literature review and case report

Kaposi Sarcoma (KS) is an intermediate neoplasm affecting the endothelial cells of mucous membranes and skin. It arises most commonly among HIV-infected individuals. We present an intra-oral KS in an 80-year-old Saudi male patient, who is HIV-seronegative, non-immunosuppressed, and with no history of organ transplantation. The patient was treated with fractionated radiation therapy, and had no recurrence in the 48 months of follow-up. The clinical disease, histologic features, and treatment modality used, as well as the relative literature are presented in this paper.

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.