Abstract
Background. Kaposi sarcoma (KS) is one of the most common neoplasms diagnosed in HIV-seropositive subjects. Oral involvement is frequent and is associated with a poor prognosis. The aim of this study was to characterize the features of oral HIV-KS in patients from Ga-Rankuwa, South Africa. Methods. All cases with confirmed oral HIV-KS treated at the oral medicine clinic in Ga-Rankuwa from 2004 to 2010 were included in this retrospective study. Differences between males and females with oral HIV-KS in relation to HIV infection status, to oral KS presentation and to survival rates were statistically analysed. Results. Twenty (54%) of the 37 patients in the study were females and 17 (46%) were males. In 21 patients (57%), the initial presentation of HIV-KS was in the mouth. Other than the fact that females presented with larger (≥10 mm) oral KS lesions (P = 0.0004), there were no statistically significant gender differences. Significantly more patients presented with multiple oral HIV-KS lesions than with single lesions (P = 0.0003). Nine patients (24%) developed concomitant facial lymphoedema, and these patients had a significantly lower CD4+ T-cell count (28 cells/mm3) compared to the rest of the group (130 cells/mm3) (P = 0.01). The average CD4+ T-cell count of the patients who died (64 cells/mm3) was significantly lower (P = 0.0004), there were no statistically significant gender differences. Significantly more patients presented with multiple oral HIV-KS lesions than with single lesions (P = 0.016) at the time of oral-KS presentation than of those who survived (166 cells/mm3). Conclusions: In Ga-Rankuwa, South Africa where HIV-KS is prevalent, oral KS affects similarly males and females. A low CD4+ T-cell count at the time of oral HIV-KS diagnosis and the development of facial lymphoedema during the course of HIV-KS disease portends a poor prognosis.
Highlights
Kaposi sarcoma (KS) is a multicentric angioproliferative disorder of endothelial origin [1, 2]
The diagnosis of KS was confirmed by microscopic examination of incisional biopsy specimens by an oral pathologist; the HIV-serostatus of the patients was determined by enzyme-linked immunosorbent assay (ELISA) and Western blot
Data were recorded with regard to patient age, race, and gender; the oral site affected by HIV-associated KS (HIV-KS); the clinical appearance of oral HIV-KS lesions; the period of HIV-seropositivity before a KS diagnosis was rendered; the CD4+ T-cell count at the time of HIV diagnosis and when HIV-KS was diagnosed; whether patients received highly active antiretroviral therapy (HAART) at the time of oral HIV-KS diagnosis, or thereafter; any KS involvement on the skin; the presence of facial lymphoedema; the presence of an immune reconstitution inflammatory syndrome (IRIS); the treatment modality used for oral HIV-KS; the course and response to treatment of oral
Summary
Kaposi sarcoma (KS) is a multicentric angioproliferative disorder of endothelial origin [1, 2]. There are four clinicoepidemiological variants of KS: classic KS, endemic KS, iatrogenic KS, and HIV-associated KS (HIV-KS) These variants develop in distinct populations of subjects, and in all of them, the mouth may be affected. The aim of this study was to characterize the features of oral HIV-KS in patients from Ga-Rankuwa, South Africa. More patients presented with multiple oral HIV-KS lesions than with single lesions (P = 0.0003). More patients presented with multiple oral HIV-KS lesions than with single lesions (P = 0.016) at the time of oral-KS presentation than of those who survived (166 cells/mm). A low CD4+ T-cell count at the time of oral HIV-KS diagnosis and the development of facial lymphoedema during the course of HIV-KS disease portends a poor prognosis
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