Abstract
Simple SummaryKaposi’s sarcoma is a rare tumor caused by human herpesvirus 8 in the context of immunodeficiency, such as that induced by HIV infection or immunosuppressive therapy. In patients living with HIV (PLHIV), thanks to potent antiretroviral treatment that efficiently restores immunity and allows a better control of HIV infection, the occurrence of KS has decreased dramatically over the past 25 years. However, KS is still one the most frequent cancers in PLHIV, in particular in men who have sex with men and in sub-Saharan Africa, where it is still endemic. Even in the context of restored immunity, the risk of KS is still more than 30 times higher in PLHIV than in the general population.Kaposi’s sarcoma is an angioproliferative tumor caused by human herpesvirus 8 in the context of immunodeficiency, such as that induced by HIV infection or immunosuppressive therapy. Its incidence has dramatically fallen in patients living with HIV (PLHIV) since the introduction of potent antiretroviral combinations 25 years ago due to the restoration of immunity and better control of HIV replication. However, KS is still one of the most frequently occurring cancers in PLHIV, in particular in men who have sex with men and in sub-Saharan Africa, where it is still endemic. Even in the context of restored immunity, the risk of KS is still more than 30 times higher in PLHIV than in the general population. Recent evidence indicates that early initiation of antiretroviral treatment, which is recommended by current guidelines, may reduce the risk of KS but it needs to be accompanied by early access to care. This review mainly focuses on the recent epidemiological features of KS in the context of HIV infection.
Highlights
Simple Summary: Kaposi’s sarcoma is a rare tumor caused by human herpesvirus 8 in the context of immunodeficiency, such as that induced by human immunodeficiency virus (HIV) infection or immunosuppressive therapy
These geographical differences are likely related to the combined effect of a higher prevalence of HHV8, a higher prevalence of HIV infection, and lower access to antiretroviral treatment (ART) in these regions
Of the large ANRS CO4 FHDH cohort [21], which investigated the incidence of cancer among more than 50,000 patients living with HIV (PLHIV) followed in France between 1998 and 2006, the risk of Kaposi’s sarcoma (KS)
Summary
Kaposi’s sarcoma (KS) is an angioproliferative tumor that was first described in its “classic form” at the end of the XIX century by a Hungarian dermatologist, Moritz Kaposi, as a rare indolent cutaneous tumor affecting elderly individuals, mostly men from Eastern. The causative agent of KS, human herpesvirus 8 (HHV-8), reported as KSHV (Kaposi’s sarcoma herpes virus), was identified in 1994 in KS lesions obtained from patients with acquired immunodeficiency syndrome (AIDS) [5]. This breakthrough discovery confirmed the previous suggestions, based on epidemiological data, that an oncogenic virus was the etiological agent of KS [6,7]. The four forms of KS, the classic (Mediterranean), endemic (African), epidemic (HIV/AIDS-associated), and iatrogenic (transplant-related), share the same causative virus but have distinct epidemiological and clinical presentations. Certain insights on post-transplantation and other KS are provided
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