Kaposi Sarcoma among HIV Infected Patients in Lagos University Teaching Hospital, Nigeria: A 14-Year Retrospective Clinicopathological Study

Abstract

Background. Despite the increased incidence of Kaposi sarcoma (KS) resulting from the Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) pandemic, there is still significant underreporting of KS in this environment. Objectives. This study was aimed at determining the incidence and clinicopathologic patterns of KS among HIV infected patients in Lagos University Teaching Hospital (LUTH), Nigeria, over a 14-year period: January 2000 to December 2013. Methodology. The materials for this study included patients' hospital clinical files, duplicate copies of histopathologic reports, and tissue blocks and corresponding archival slides in the Anatomic and Molecular Pathology Department and the HIV/AIDS unit of the Department of Haematology. Results. Within the study period, 182 cases of KS were diagnosed, accounting for 1.2% of all patients managed for HIV/AIDS and 2.99% of solid malignant tumours. The male-to-female ratio and modal age group were 1 : 1.3 and 5th decade, respectively. Most cases (90%) had purely mucocutaneous involvement with the lower limb being the commonest site (65.8%). The majority of lesions were plaques (65.8%). Vascular formation was the predominant histologic type seen (43.5%). Conclusion. KS in Lagos followed the same epidemiologic trend as other centers in Nigeria, with an increasing incidence in this era of HIV/AIDS.

Clinical features of Kaposi's sarcoma: experience from a Taiwanese medical center

“…We also found that the disease was more frequent in males compared with females (10 : 1 ratio), especially in the AIDS‐associated form where all patients were males. Although KS is known to have a male predominance, the male to female ratio in our patient population is even greater than that found in studies from other countries (male‐female ratio 3 : 1 in large epidemiological studies) . In addition, AIDS‐related cases were mostly younger (between 20 and 45 years) than HIV negative cases (older than 50 years), which corroborates with data from the literature …”

“…Kaposi's sarcoma (KS) is a vascular tumor which is associated with human herpesvirus 8 (HHV‐8) infection . Clinically, there are four recognized types of KS including classic, acquired immune deficiency syndrome (AIDS)‐associated (epidemic), African (endemic), and iatrogenic (immunosuppressive medication‐related) .…”

Evaluation of clinical course, histopathological and treatment characteristics of patients with Kaposi's sarcoma

“…Among patients with the classical KS in our study, the male/female ratio was 2.08%, which was lower than previously reported 8,11 . The mean age of our patients with the classical KS was 68.8 years, which was similar to that in most of studies reported previously but greater than that reported by Wu et al 3,9,11,12 KS patients with HIV positivity had a mean age of 41 years, which was similar to that reported by Akinde et al 5 among HIV -positive KS patients. It has been reported that KS may be accompanied by secondary malignancies 13 .…”

“…KS was first defined by Moritz Kaposi in 1872, and is typically characterized by vascular skin lesions of low malignant potential. It particularly affects elderly men of Italian, Jewish, or Mediterranean descent 3,5 . Its incidence varies by geographical region.…”

“…We also identified the nodular stage as the most common stage, with a rate of 53.2%. Akinde et al 5 reported the plaque stage as the most commonly encountered stage among HIV -positive patients with KS. We similarly identified the plaque stage in 75% of HIV -positive patients.…”