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

Abstract

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.

Sarcoma de Kaposi en Infección por VIH captado en atención primaria, a propósito de un caso

“…El SK adquirido, se desarrolla en individuos inmunodeprimidos por el uso de fármacos, trasplante de órganos o una enfermedad autoinmune. El SK endémico, propio del continente africano, causa lesiones cutáneas sin ningún otro síntoma; siendo estas localizadas sin diseminación a otras partes del cuerpo (10). La patogenia del SK asociado a VIH/SIDA, está relacionado con la disminución o pérdida de la competencia del sistema inmune del paciente.…”

Disseminated Kaposi Sarcoma

“…Kaposi sarcoma related to AIDS occurs in patients with cluster of differentiation four (CD4) counts less than 200 cells per cubic millimeter and is an AIDS-defining illness. 1 Etiology is human herpesvirus-8, which causes endothelial cell proliferation leading to vascular neoplasia with multisystem involvement. 2 Presentation includes erythematous or violaceous macules and plaques that progress to tumors or nodules.…”

CE: HIV-Associated Kaposi Sarcoma in the Combination Antiretroviral Therapy Era

“…Having a low CD4 + count substantially increases the risk of developing Kaposi sarcoma 35 ; the median CD4 + count at diagnosis is 175 cells/mm 3 . 36 (For background on the relationship between CD4 + and HIV, see CD4 + T-Cell Counts and HIV. 37 ) Also, Kaposi sarcoma most often affects PLWH who have detectable viral loads, including those whose viral load remains high despite being on cART, which may be for various reasons, including drug resistance or inconsistent adherence to treatment.…”

“…Kaposi sarcoma is more common among individuals with uncontrolled HIV. Having a low CD4 + count substantially increases the risk of developing Kaposi sarcoma35; the median CD4 + count at diagnosis is 175 cells/mm3 36. (For background on the relationship between CD4 + and HIV, see CD4 + T-Cell Counts and HIV 37…”