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Aramburu González A, Acebo Mariñas E, Orbea Sopeña A, Lasa Elgezua O. Primary vulval classic Kaposi's sarcoma in an HIV-negative woman. Australas J Dermatol 2021; 62:e449-e451. [PMID: 33909288 DOI: 10.1111/ajd.13587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 02/07/2021] [Accepted: 02/14/2021] [Indexed: 11/26/2022]
Affiliation(s)
| | | | - Ana Orbea Sopeña
- Department of Dermatology, Cruces University Hospital, Vizcaya, Spain
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Kaposi Sarcoma among HIV Infected Patients in Lagos University Teaching Hospital, Nigeria: A 14-Year Retrospective Clinicopathological Study. J Skin Cancer 2016; 2016:9368023. [PMID: 27034839 PMCID: PMC4808559 DOI: 10.1155/2016/9368023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 02/13/2016] [Accepted: 02/14/2016] [Indexed: 12/04/2022] Open
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.
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Chalya PL, Mbunda F, Rambau PF, Jaka H, Masalu N, Mirambo M, Mushi MF, Kalluvya SE. Kaposi's sarcoma: a 10-year experience with 248 patients at a single tertiary care hospital in Tanzania. BMC Res Notes 2015; 8:440. [PMID: 26374100 PMCID: PMC5439227 DOI: 10.1186/s13104-015-1348-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 08/17/2015] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Kaposi's Sarcoma is the most common sarcoma and second most prevalent cancer seen in Tanzania. Little is known about Kaposi's sarcoma in our setting as there is paucity of recent published data regarding this condition. This study describes the clinicopathological pattern and treatment outcome of Kaposi's sarcoma at Bugando Medical Centre, a tertiary care hospital in northwestern Tanzania. METHODS This was a prospective study of histologically confirmed Kaposi's sarcoma that was conducted at Bugando Medical Center between July 2004 and June 2014. RESULTS A total of 248 patients (M:F = 1.4:1) representing 2.4% of all malignancies during the study period were enrolled into the study. The median age at presentation was 36 years. Females were younger than males (p = 0.04). Out of 248 patients, 122 (49.2%) were HIV positive. Of these, 46 (37.7%) were males and 76 (62.3%) females. AIDS-related Kaposi's sarcoma were younger than HIV negative Kaposi's sarcoma patients (p = 0.011). Median duration of symptoms was 6 months. Kaposi's sarcoma was the AIDS defining disease in 82 (67.2%) patients while in the remaining 40 (32.8%) it was diagnosed between 1 and 14 months after the initial diagnosis of AIDS. The lower limb was most frequently involved site in 28.9% of patient. Females had more disseminated lesions compared with more localized lesions in the males (p = 0.001). The treatment modalities in this study included chemotherapy, radiotherapy, surgery and highly active antiretroviral therapy. Overall 126 (53.4%) patients had significant improvement in quality of life at the end of 1 year follow up. Treatment related complication and mortality rates were 25.8 and 24.2% respectively. Poor ACTG stage, CD4+ count <200 cells/µl, associated co-morbid illness, disseminated disease and poor adherent to chemotherapy were the significant independent factors associated with deaths (p < 0.001). Patient's follow-up was generally poor and data on long-term survivals were not available as more than two-thirds of patients were lost to follow up. CONCLUSION Kaposi's sarcoma is the most common malignant vascular tumor and HIV/AIDS- related cancer in our region. There is an urgent need to develop health education programmes to enhance the understanding of this disease and how it spreads, particularly among the younger generation.
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Affiliation(s)
| | - Fidelis Mbunda
- Department of Surgery, Bugando Medical Centre, Mwanza, Tanzania
| | - Peter F Rambau
- Department of Pathology, Catholic University of Health and Allied Science-Bugando, Mwanza, Tanzania
| | - Hyasinta Jaka
- Department of Internal Medicine, Catholic University of Health and Allied Science-Bugando, Mwanza, Tanzania
| | - Nestory Masalu
- Department of Oncology, Bugando Medical Centre, Mwanza, Tanzania
| | - Mariam Mirambo
- Department of Microbiology, Catholic University of Health and Allied Science-Bugando, Mwanza, Tanzania
| | - Martha F Mushi
- Department of Microbiology, Catholic University of Health and Allied Science-Bugando, Mwanza, Tanzania
| | - Samuel E Kalluvya
- Department of Internal Medicine, Catholic University of Health and Allied Science-Bugando, Mwanza, Tanzania
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Van Bogaert LJ. Does the knowledge of the human immunodeficiency virus serostatus influence the clinical diagnostic proficiency of Kaposi's sarcoma? S Afr Fam Pract (2004) 2013. [DOI: 10.1080/20786204.2013.10874398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- LJ Van Bogaert
- National Health Laboratory Service, Polokwane Mankweng Hospital Complex and University of Limpopo
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van Bogaert LJ. Anogenital Lesions: Kaposi's Sarcoma and Its Mimicks. ISRN AIDS 2012; 2012:486425. [PMID: 24052876 PMCID: PMC3767349 DOI: 10.5402/2012/486425] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Accepted: 09/13/2012] [Indexed: 11/23/2022]
Abstract
Kaposi's sarcoma (KS) is a low-grade vascular neoplasm associated with human herpes virus-8 (HHV-8) infection, and, in the epidemic form, with the human immunodeficiency virus (HIV). Although HHV-8 is present in all body fluids and is sexually transmitted, there are surprisingly few reports of anogenital KS. Clinically, especially in HIV/KS endemic areas, dark stained skin patches or nodules are prone to misdiagnosis, especially in dark-skinned individuals. Therefore, a biopsy is recommended. The histologic appearance spans a broad spectrum of KS and non-KS lesions; therefore, the final diagnosis should be confirmed by HHV-8 immunohistochemistry. We report a series of 36 anogenital biopsies from a group of 16 documented HIV-positive patients; in 20 the HIV serostatus was unknown. There were ten KS (five in HIV-positive patients), and 26 non-KS (11 in HIV-positive subjects) lesions. In the era of HIV/AIDS, anogenital lesions may be the first manifestation of KS in immunocompromised individuals and should be biopsied. The histological diagnosis should be confirmed by HHV-8 immunohistochemistry.
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Affiliation(s)
- Louis-Jacques van Bogaert
- National Health Laboratory Service, Polokwane/Mankweng Hospital Complex and University of Limpopo, Groblersdal 0470, South Africa
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Saturday Morning Science Programs: A Model to Increase Diversity in the Biosciences. J Natl Med Assoc 2012; 104:377-83. [DOI: 10.1016/s0027-9684(15)30180-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Mosam A, Uldrick TS, Shaik F, Carrara H, Aboobaker J, Coovadia H. An evaluation of the early effects of a combination antiretroviral therapy programme on the management of AIDS-associated Kaposi's sarcoma in KwaZulu-Natal, South Africa. Int J STD AIDS 2012; 22:671-3. [PMID: 22096054 DOI: 10.1258/ijsa.2009.009145] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Roll-out of combination antiretroviral therapy (cART) in South Africa should impact on AIDS-associated Kaposi's sarcoma (KS). Government provision began in 2003, with 23% coverage for World Health Organization (WHO) stage IV AIDS in 2006. To assess the effect of cART availability on KS management, we evaluated records from 701 KS patients seen at a tertiary oncology centre in KwaZulu-Natal, South Africa, from 1995 to 2006. Associations between cART use and measures of KS care were evaluated. cART availability was 0% prior to 2001, 9.6% (2001-2003) and 44% (2004-2006). Documentation of HIV status increased incrementally from 65% to 92%. cART was associated with chemotherapy administration: 56% on cART versus 17% not on cART (P < 0.001); and less loss to follow-up, 13% on cART versus 38% not on cART (P < 0.001). cART availability improves the care of AIDS-associated KS. Further increases in cART availability for this population are needed in South Africa.
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Affiliation(s)
- A Mosam
- Department of Dermatology, Nelson R Mandela School of Medicine, CAPRISA, University of KwaZulu-Natal, Durban, South Africa.
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Agaba PA, Sule HM, Ojoh RO, Hassan Z, Apena L, Mu'azu MA, Badung B, Agbaji OO, Idoko JA, Kanki P. Presentation and survival of patients with AIDS-related Kaposi's sarcoma in Jos, Nigeria. Int J STD AIDS 2009; 20:410-3. [PMID: 19451327 DOI: 10.1258/ijsa.2008.008353] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
AIDS-related Kaposi's sarcoma (AIDS-KS) remains a significant cause of morbidity and mortality. We describe the pattern of presentation and survival in Jos, Nigeria. We identified 48 HIV-positive patients with AIDS-KS and matched them for age and sex with an equal number of HIV-positive patients without AIDS-KS. We compared their clinical, immunological, virological characteristics and survival. They were similar in age and body mass index profile but patients with AIDS-KS had more tuberculosis co-infection (P, 0.02), lower median CD4 count (P, 0.003) and higher mortality (P, 0.002). Surprisingly, patients with AIDS-KS had lower levels of median viral load (29,347 copies/mL) compared with controls (80,533 copies/mL). We recommend specific AIDS-KS therapy in addition to highly active antiretroviral therapy in order to improve survival.
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Affiliation(s)
- P A Agaba
- AIDS Prevention Initiative Nigeria (APIN) Centre, Jos University Teaching Hospital, Jos, Plateau State, Nigeria.
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Asuquo M, Umana A, Otei O, Bassey I, Ebughe G. Kaposi sarcoma in calabar, southern Nigeria. Oman Med J 2009; 24:33-6. [PMID: 22303507 DOI: 10.5001/omj.2009.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Accepted: 01/25/2009] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES There has been an increase in the prevalence of Kaposi sarcoma (KS) with the emergence of Human Immunodeficiency Virus (HIV). METHODS Patients with histologic diagnosis of KS seen in the University of Calabar Teaching Hospital, Calabar between January 2007 and December 2008 were studied. Diagnosis of HIV was based on enzyme linked immunosorbent assay (ELISA). RESULTS In total, 15 patients (10 males, 5 females, M: F=2:1) presented with KS and accounted for 33.0% of total skin malignancy and ranked second after squamous cell carcinoma, 42.0%. Their ages ranged from 5 and 60 years (mean 37.5 years). Twelve patients (M=8, F=4), 80%, were HIV seropositive, while 3 (M=2, F=1) were HIV seronegative. The lower limb was the commonest affected site, 57.9%. CONCLUSION The most common clinical type was HIV related KS. Ignorance, sociocultural beliefs, poverty, late presentation were underlying issues.
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Ramos Rincón JM, Zubero Sulibarría Z, Ena Muñoz J. [Immigration and HIV Infection. An approximation to parasitic and viral infections]. Enferm Infecc Microbiol Clin 2008; 26 Suppl 5:42-53. [PMID: 18590665 DOI: 10.1157/13123266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Highly-active antiretroviral therapy is effective in reducing opportunistic infections in industrialized countries. However, opportunistic parasitic infections remain the leading cause of HIV-related mortality in developing countries. These infections can also affect HIV-positive immigrants residing in Spain, as well as HIV-infected patients traveling to low-income countries. In addition, immigrants often have viral infections caused by herpesvirus, papillomavirus and polyomavirus, which are closely related to risk behaviors and commercial sex. The present article reviews the characteristics of parasitic and viral infections in patients with HIV infection with the aim of improving understanding of this vulnerable population group.
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Clinical Evaluation of Kaposi Sarcoma in HIV/AIDS Patients With Orofacial Lesions in Enugu, Nigeria. J Oral Maxillofac Surg 2008; 66:1362-5. [DOI: 10.1016/j.joms.2007.08.049] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2007] [Accepted: 08/22/2007] [Indexed: 11/23/2022]
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