Kaposi's sarcoma among persons with AIDS: a sexually transmitted infection?

Abstract

In the United States Kaposi's sarcoma is at least 20,000 times more common in persons with acquired immunodeficiency syndrome (AIDS) than in the general population and 300 times more common than in other immunosuppressed groups. Among persons with the acquired immunodeficiency syndrome (AIDS) reported to Centers for Disease Control by March 31, 1989, 15% (13,616) had Kaposi's sarcoma. Kaposi's sarcoma was commoner among those who had acquired the human immunodeficiency virus (HIV) by sexual contact than parenterally, the percentage with Kaposi's sarcoma ranging from 1% in men with haemophilia to 21% in homosexual or bisexual men. Women were more likely to have Kaposi's sarcoma if their partners were bisexual men rather than intravenous drug users. Kaposi's sarcoma risk was not consistently related to age or race but varied across the United States, being greatest in the areas that were the initial foci of the AIDS epidemic. Thus Kaposi's sarcoma in persons with AIDS may be caused by an as yet unidentified infectious agent, transmitted mainly by sexual contact.

HHV‐8 subtypes in South Africa: Identification of a case suggesting a novel B variant

“…Four major clinical forms have since been described [Giraldo et al, 1989;Martin et al, 1993]: (1) epidemic or acquired immunodeficiency syndrome AIDS-associated; (2) classic; (3) African endemic; and (4) immunosuppressionassociated (iatrogenic) Kaposi's sarcoma [Giraldo et al, 1989;Beral et al, 1990;Martin et al, 1993]. African endemic Kaposi's sarcoma clusters among Africans from East and Central Africa and accounts for 3-18% of all malignancies in these regions [Martin et al, 1993;Gompels and Kasolo, 1996;Lennette et al, 1996;Kasolo et al, 1997].…”

Recent insights into the pathogenesis of Kaposi's sarcoma

“…Furthermore, there is evidence that classical KS was increasing before the AIDS epidemic, with a doubling of incidence in Sweden over 25 years before 1982 (Dictor andAttewell, 1988). In the USA there is now a consistent decrease in the incidence of AIDS-KS (Beral et al, 1990), with a 4-fold fall among a cohort of homosexual men with AIDS between 1983(Katz et al, 1994 Huang et al, 1995;Boshoff et al, 1995;Dupin et al, 1995;Moore and Chang, 1995;Lebbe et al, 1995;Schalling et al, 1995). The agent was also identified in African endemic KS (Huang et al, 1995;Lebbe et al, 1995;Schalling et al, 1995).…”

“…Analysis of 13 000 persons with AIDS reported to the Centres for Disease Control, Atlanta, GA, USA, up to 1989 revealed that the incidence of KS in homosexual and bisexual men infected with HIV is ten times greater than in other seropositive transmission groups (Beral et al, 1990). The lifetime incidence in some cohorts of homosexual men with AIDS is 50% (Katz et al, 1994).…”

“…Geographical clustering of KS cases in the USA has been demonstrated. The incidence of KS is increased in all AIDS transmission groups on the west coast and around New York, the areas of the original epidemic, compared with other regions (Beral et al, 1990). Moreover, women with AIDS are four times more likely to develop KS if they acquired HIV infection from a bisexual partner rather than from an intravenous drug user (Beral et al, 1990).…”

Gastrointestinal tract spindle cell lesions—just like real estate, it's all about location

“…The risk of developing KS for untreated AIDS patients is estimated to be 300 times greater than that of other immunosuppressed individuals and 20 000 times greater that of the general population. 18 In this group, KS frequently assumes an aggressive course. Areas prone to KS in the adult AIDS population include: the oral cavity, especially the hard palate, the tip of the nose, behind the ears, the trunk, penis, legs, and feet.…”