Abstract
Kaposi’s sarcoma (KS) was peculiarly described in the first notified cases of the acquired immunodeficiency syndrome as an opportunistic condition. However, the medical progress and the development of active antiretroviral therapy allowed the control of the HIV/AIDS epidemic, although the features of KS have changed throughout the past decades. The purpose of our study is to assess the epidemiological and clinical features of AIDS related KS in Romanian patients. A retrospective follow-up study was achieved in a single infectious diseases’ clinic from Galati—Romania, between 2001 and 2021. Referring to 290 new HIV diagnosed cases from our clinic retained in care, the prevalence of KS was 3.4%. The main characteristics of patients with KS are a median age of 33, a predominance of males, prevalent severe systemic forms of diseases, frequent association of past or concomitant tuberculosis, and context of immune reconstruction syndrome. The mortality rate was 70%. KS has occurred in patients with delayed HIV diagnoses and inadequate adherence to therapy. Early recognition of both infections, the close monitoring of latent or symptomatic tuberculosis, improving the antiretroviral adherence and raising the access to oncologic procedures in Romanian HIV patients could improve their prognosis related to KS.
Highlights
Moritz Kaposi has described angioproliferative tumours in the elderly since 1872, which have been called Kaposi’s sarcomas (KS)
KS in young men who had sex with men (MSM) was reported in 1981, among the first defining opportunistic diseases related to acquired immunodeficiency syndrome (AIDS), with an estimated frequency of over 30% [5]
We have identified the cases with HIV/AIDS and diagnosis of KS
Summary
Moritz Kaposi has described angioproliferative tumours in the elderly since 1872, which have been called Kaposi’s sarcomas (KS). Four subtypes of KS are presently recognised: the classical form, found in the Mediterranean region, predominantly affecting the lower limbs, assimilated to the initial description of Kaposi in the elderly people; the endemic form, specific to the children from the African area, with severe evolution, including lymphadenopathic manifestations; the iatrogenic form, occurring in patients post-transplant or other patients receiving immunosuppressive treatment; and the AIDS related KS, usually with generalized, severe, even fatal evolution [3,4]. The overall incidence of KS was assessed in a comprehensive meta-analysis, which compared data for different population categories, proving that HIV-positive people have an annual incidence of this neoplasm of 481.54/100,000, significantly higher than people with organ transplants (68.59/100,000), children with HIV infection (52.94/100,000) and compared to the general population (1.53/100,000) [3]. In the HIV-infected population, the incidence was higher in men than in women, in men with MSM than in heterosexuals, and in untreated people versus people with highly active antiretroviral therapy (HAART) [6]
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