Kaposi’s sarcoma, a South African perspective: Demographic and pathological features

Mohanlal, Reena Dhansukh; Pather, Sugeshnee

doi:10.7196/samj.8773

Cited by 6 publications

(5 citation statements)

References 20 publications

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“…In this study, a majority of patients diagnosed with KS were male, HIV positive, and had significantly lower CD4 cell counts than those with alternative diagnoses on histopathology, which are consistent with prior studies from countries throughout SSA . The average age of our KS cohort was also similar to those reported in the literature (mid to late 30s) . Endemic KS, KS occurring in absence of HIV infection, accounted for only a limited proportion of cases (6.4%).…”

Section: Discussionsupporting

confidence: 90%

A retrospective review of patients with Kaposi's sarcoma in Botswana

et al. 2018

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Background Despite widespread antiretroviral coverage in Botswana, Kaposi’s sarcoma (KS) remains among the most common malignancies. To date, adult KS in Botswana is not well characterized. The diagnosis relies on clinical suspicion that is often confirmed by histopathology given the implications of treatment; however, this poses a significant resource burden. Methods We conducted a retrospective review of the cohort of patients biopsied for possible KS at Princess Marina Hospital, the main dermatology referral site in Botswana, from September 2008 through June 2015 to describe the demographics, human immunodeficiency virus (HIV) characteristics, and clinical presentations of these patients. Histopathologic diagnoses were reviewed, and positive predictive value (PPV) was used to characterize the accuracy of clinical suspicion of KS. Results A total of 441 patients received 450 biopsies where KS was on the differential diagnosis, and 239 patients (54%) were ultimately diagnosed with KS. The KS cohort was more likely to be male (58% vs. 37%, P < 0.001), HIV positive (94% vs. 85%, P < 0.05), and have lower CD4 counts at the time of biopsy (274 cells/μ vs. 362 cells/μl, P < 0.05). The PPV of clinical suspicion of KS was 58%. When KS was not histopathologically diagnosed, clinically benign diseases were found in 17%, medically significant conditions requiring alternative therapies in 78%, and life-threatening diseases in 5%. Discussion Our study reinforces the risk factors in development of KS. The poor PPV supports the important role of histology in KS diagnosis to both ensure appropriate treatment and prevent overtreatment. Improved accessibility to biopsy and augmentation of local dermatopathologic services would likely improve diagnostic accuracy and treatment.

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Section: Discussionsupporting

confidence: 90%

A retrospective review of patients with Kaposi's sarcoma in Botswana

et al. 2018

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“…Besides, visceral lesions were present in 3.0% of the patients. These results are similar to those of previous reports [15,16,25]. Lymphedemas and papulonodules were the major types of lesion.…”

Section: Discussionsupporting

confidence: 83%

“…The slight difference we observed between men and women coincides with other reports from Cameroon [14], South Africa [15], and Tanzania [16]. In some other studies, men were even twice to thrice more numerous than women [17][18][19].…”

Section: Discussionsupporting

confidence: 78%

“…The seemingly high prevalence of human herpesvirus 8 among the Bantus when compared to the other ethnic groups in Cameroon could explain the higher frequency of KS within this ethnic group considering the close relationship between this virus and KS [22]. Comorbidities such as buccal candidiasis, tuberculosis, and prurigo were common in this study; this observation was also made by other authors [3,15,16].…”

Section: Discussionsupporting

confidence: 71%

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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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“…404,424 Among an estimated 66,200 cases of KS worldwide, 58,800 are believed to have occurred in sub-Saharan Africa. 426 The incidence of endemic KS in Africa is more common in males and adults > 35 year old. 398 Endemic KS in Africa is more aggressive than classic KS in Europe and Mediterranean Countries.…”

Section: Endemic Kaposi Sarcoma In Sub-saharan Africamentioning

confidence: 99%

Herpesvirus Respiratory Infections in Immunocompromised Patients: Epidemiology, Management, and Outcomes

Reid

Lynch

Weigt

et al. 2016

Semin Respir Crit Care Med

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Among immunocompromised individuals, members of the human Herpesviridae family are frequently encountered pathogens. Cytomegalovirus, herpes simplex virus 1 and 2, varicella zoster virus, Epstein-Barr virus, and human herpesvirus-6, -7, and -8 all establish latency after infection and can reactivate during periods of immunosuppression, leading to both direct and indirect adverse effects on the host including severe organ dysfunction as well as allograft rejection and loss after transplantation. While not all herpesviruses are primary respiratory pathogens, many of their manifestations include involvement of the respiratory tract. This article discusses the individual viruses, their epidemiology, and clinical manifestations as well as recommended treatment and preventive strategies.

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Kaposi’s sarcoma, a South African perspective: Demographic and pathological features

Cited by 6 publications

References 20 publications

A retrospective review of patients with Kaposi's sarcoma in Botswana

A retrospective review of patients with Kaposi's sarcoma in Botswana

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

Herpesvirus Respiratory Infections in Immunocompromised Patients: Epidemiology, Management, and Outcomes

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