Determinants of Kaposi Sarcoma during HIV infection: A nested case-control study from Yaoundé, Cameroon

Nansseu, Jobert Richie; Kouotou, Emmanuel Armand; Tounouga, Dahlia Noëlle; Bissek, Anne-Cécile Zoung-Kanyi

doi:10.1016/j.idh.2018.07.003

Cited by 5 publications

(4 citation statements)

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“…These finding are in agreement with those from a number of studies which have linked the immunologic and virologic status of patients to their risk of development of KS. 15,16 In an earlier study in Jos Nigeria, the median CD4+ cell count was significantly higher among those who did not have KS compared with those who had. However against expectation, the median viral load was higher among those without KS compared to those with KS in that study.…”

Section: Discussionmentioning

confidence: 93%

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Prevalence and predictors of Kaposi’s sarcoma among HIV patients receiving care at a tertiary hospital in Jos, Nigeria

Daboer

Chingle

Puepet

et al. 2021

Journal of Global Health Reports

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BackgroundKaposi's sarcoma became prevalent with the appearance of human immune deficiency virus (HIV) in the 1980s. However, the widespread use of the highly active antiretroviral therapy (HAART) reduced its prevalence in communities with good access to the antiretroviral drugs. The objective of this study was to determine the prevalence and predictors of Kaposi's sarcoma among persons receiving HIV care at a tertiary hospital in Jos, Nigeria. MethodsThe study used a cross-sectional study design, based on secondary data related to patients who had received HIV care between January 2004 and December 2017. Logistic regression was then used to determine the variables that were predictors of Kaposi's sarcoma risk. ResultsThe prevalence of Kaposi's sarcoma among the patients was 1.2% (95% confidence interval, CI=1.06-1.34). Patients whose baseline viral loads were higher than 10,000 copies/mm 3 were three times more likely to develop Kaposi's sarcoma than those with lesser viral load (OR: 3.13, CI: 2.19-4.47). Gender, duration of HAART and education had modifying effect on the Kaposi's sarcoma risk. ConclusionsKaposi's sarcoma is a substantial public health problem among the HIV population in Jos. Universal access to HAART by the Federal Government of Nigeria and its partners is recommended to reduce its prevalence. In addition, education, skill acquisition and income generating programs should be targeted at girls and women by governments and other stakeholders in order to reduce the inequality that worsens their vulnerability to HIV infection and Kaposi's sarcoma.Kaposi's sarcoma (KS) is an angio-proliferative malignancy that affects the endothelium of blood vessels. It predominantly affects the skin at different sites and can progress and regress depending on the immunity of the host. 1 KS is one of the most common malignancies in the world and the most important AIDS defining cancer (ADC). 2 The Human Herpes Virus type 8 (HHV-8) is a necessary, but not sufficient cause of KS. 3 The prevalence of KS is higher among the human immunodeficiency virus (HIV) infected population than the general population and it varies widely among different HIV infected populations. [4][5][6][7][8][9] It is not certain what factors predict the development of KS among the HIV infected persons. In the late stages of the HIV infection, KS runs a very aggressive course, suggesting the modifying role of lowered immunity in its development and progression. 9 However, some HIV patients treated with the highly active antiretroviral therapy (HAART), and who experience a substantial restoration of the CD4+ cell count have also been reported to develop KS, even at this stage, suggesting that there may be other factors at play. 2 The advent of HAART has reduced the incidence of KS in Europe and North America, but disaggregated data even in such societies have provided evidence of stagnant or even worsening incidence of KS among certain population subgroups. 9 This is often attributed to the inequality in access to HAART in those populations. In l...

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Section: Discussionmentioning

confidence: 93%

“…The finding is similar to the 1.2% earlier found in Lagos, 14 but lower than what was found in other studies. 15,16 In Zaria, a city located in northern Nigeria, a KS prevalence of 1.4% was documented. 17 All the findings above are, however, higher than the 0.6 % 8 and 0.8% 4 found earlier in Kano and Abuja respectively.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and predictors of Kaposi’s sarcoma among HIV patients receiving care at a tertiary hospital in Jos, Nigeria

Daboer

Chingle

Puepet

et al. 2021

Journal of Global Health Reports

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“…Notwithstanding, a substantial number of patients (43.6%) had CD4 counts ≥200 cells/mm 3 , with almost 18.5% of the patients having ≥350 cells/mm 3 . This finding implies that apart from the severe immunodeficiency induced by HIV infection, there are other factors involved in the development of epidemic KS [10,11]. Indeed, it was claimed that KS can occur in the course of HIV infection irrespective of the immune status [1,26].…”

Section: Discussionmentioning

confidence: 99%

“…Accordingly, this study purposed to describe the epidemiological and clinical patterns of KS among HIV-infected patients living in Cameroon, while in another paper we investigated KS risk factors among HIV-infected patients [11].…”

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confidence: 99%

Epidemiological and Clinical Patterns of Kaposi Sarcoma: A 16-Year Retrospective Cross-Sectional Study from Yaoundé, Cameroon

Tounouga

Kouotou²,

Nansseu³

et al. 2018

Dermatology

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Background: The burden of Kaposi sarcoma (KS) is increasing fast among HIV-infected populations, but the disease remains desperately underexplored in Cameroon, where the burden of HIV is high. Methods: This is a retrospective cross-sectional study carried out over a period of 16 years (January 2001 to December 2016) at the HIV day care unit of the Central Hospital of Yaoundé, Cameroon. The diagnosis was based on clinical aspects and histological confirmation, and we used a preconstructed questionnaire for data collection through patients’ electronic and physical files. Results: Among 14,220 files reviewed, 316 cases of KS were identified, yielding a cumulative incidence of 2.2%. In the end, 266 patients (55% male) were included in this study. The patients’ age ranged from 17 to 72 years, with a mean of 37.8 ± 9.5 years. KS was the presenting manifestation of HIV in 89.8% of the cases. Cutaneous lesions occurred more often (81.6%), mainly located on the lower limbs (47.7%); mucous lesions were found in 15.8% of the patients, while 8 patients (3.0%) had associated visceral lesions. The lesions predominantly were lymphedemas (28.6%) and papulonodules (21.1%). At the diagnosis of KS, the median CD4 count was 175 cells/mm³ (interquartile range 80.5–288.5), and 150 patients (56.6%) had CD4 counts < 200 cells/mm³. Conclusions: KS is frequent among our HIV-infected patients; it seems to occur most often at a younger adult age and represents one of the presenting manifestations of HIV/AIDS in our context. It seems to equally affect men and women, occurring more often when CD4 counts are < 200 cells/mm³.

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Lifestyle factors associated with sex differences in Kaposi sarcoma incidence among adult black South Africans: A case-control study

Motlhale

Sitas

Bradshaw

et al. 2022

Cancer Epidemiology

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Determinants of Kaposi Sarcoma during HIV infection: A nested case-control study from Yaoundé, Cameroon

Cited by 5 publications

References 18 publications

Prevalence and predictors of Kaposi’s sarcoma among HIV patients receiving care at a tertiary hospital in Jos, Nigeria

Prevalence and predictors of Kaposi’s sarcoma among HIV patients receiving care at a tertiary hospital in Jos, Nigeria

Epidemiological and Clinical Patterns of Kaposi Sarcoma: A 16-Year Retrospective Cross-Sectional Study from Yaoundé, Cameroon

Lifestyle factors associated with sex differences in Kaposi sarcoma incidence among adult black South Africans: A case-control study

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