Kaposi’s Sarcoma Trends in the Era of Highly Active Antiretroviral Therapy in Zambia

Abstract

AIDS-related Kaposi’s Sarcoma (KS) is a multi-centric angiogenic neoplastic proliferation predominantly seen in individuals with Human Immune Virus (HIV-1) infection and men who have sex with men. Although the incidences of aggressive KS have reduced following the introduction of Highly Active Antiretroviral Therapy (HAART) in the treatment of HIV infection, the effect of HAART rollout in relation to population KS incidence in Zambia remains unclear as cases of the malignancy have continued to be reported. This study, investigated the trends of KS in the era of HAART in Zambia. The researchers conducted a retrospective cross-sectional study. Three hundred and twentycases of HIV-infected individuals on HAART that developed KS between 2008 and 2017 were reviewed. Data was retrieved from the Zambia National Cancer Registry (ZNCR). Of the records reviewed, the researchers observed a sharp increase in KS cases from 5.6 per cent in 2008 to 21.2 per cent in 2014; from 2015 to 2017, there was a general decline in KS cases countrywide in both sexes from 13.1 per cent to 9.4 per cent. KS was more prevalent in Lusaka Province, while Western Province had the least number of cases. For each province, there were more males affected by KS than females. The researchers further observed that 19.1 per cent of the cases reviewed developed KS while on HAART, while 80.9 per cent developed KS before the commencement of HAART. The age group with the highest number of KS cases was 21-40 years, while the age group ≥ 80 had the least number of cases. Our data has shown that although there has been a general decline in KS cases across the ten provinces of Zambia in recent years, more efforts are still required to mitigate AIDS-related KS incidence and improve KS prognosis. There is a need to encourage efforts aimed at HIV infection prevention, wide coverage of HAART across the country, and KS awareness and screening.