Clinical and laboratory characteristics, staging, and outcomes of individuals with AIDS-associated Kaposi's sarcoma at an university hospital

Abstract

BackgroundKaposi's sarcoma continues to be the most common human immunodeficiency virus - associated neoplasm with considerable morbidity and mortality.ObjectiveTo describe the clinical and laboratory characteristics, initial staging, and outcomes of aids patients with Kaposi's sarcoma at an university hospital of Recife, Pernambuco.MethodsThis is a descriptive study with analytic character, retrospective, of a case series between 2004 and 2014.ResultsOf the 22 patients included in the study, 20 were aged <40 years (72.7%). The majority had CD4+ T lymphocyte counts of <200 cells/mm3 (77.3%) and human immunodeficiency virus loads of <100,000 copies/mL (78.9%). Lesions were most commonly observed on the skin (90%), and internal organs were affected in 11 of the 22 patients. Only 7 (31.8%) of the 22 patients were undergoing antiretroviral therapy (ART) at the time of Kaposis sarcoma diagnosis, and the initial disease staging classification was high risk (Aids Clinical Trials Group Oncology Committee) in 19 of the 22 patients (86.4%). Regarding Kaposi's sarcoma treatment, 17 of 22 patients (77.3%) underwent systemic chemotherapy + ART and 5 were treated exclusively with ART. Eight of the 22 patients died (36.5%); of these, 87.5% had died within one year of Kaposi's sarcoma diagnosis.Limitation of the studyWithout a control group, this study cannot be used to generate hypotheses.ConclusionsDespite the association between aids and late Kaposi's sarcoma diagnosis in the study population, including an unfavorable risk at the time of staging, a lower mortality rate was observed relative to other studies; this might be related to access to a specialized health service.

Analyses of Kaposi Sarcoma trends among adults establishing initial outpatient HIV care in Nigeria: 2006–2017

“…Similar to what we found, recent studies from low- and middle-income countries (LMICs) suggest that, despite significant expansion of HIV programs in these regions, KS may remain an important cause of morbidity and mortality among patients newly enrolling for HIV care [ 27 – 29 ]. A recent multinational study across Latin American countries reported that the risk for KS was 41% lower in 2005 compared to 2010 (adjusted HR 0.59, 95% CI 0.40–0.87), and 70% higher in 2012 (adjusted HR 1.70, 95% CI 1.37–2.09) [ 28 ].…”

Incidence and Risk Factors for Suicide Death among Kaposi’s Sarcoma Patients: A Surveillance, Epidemiology, and End Results Analysis

“…However, after the antiretroviral therapy (ART) was widely used from 1996, the KS incidence dropped dramatically [11,12]. KS can cause skin lesions of purple, red, or brown spots, most often on the legs or face, but they can also develop in other parts of the body [13,14]. These skin lesions are very prominent and may attract attention from colleagues or passersby, which is a huge social and psychological burden for the patient.…”

Yield of FDG PET/CT for Defining the Extent of Disease in Patients with Kaposi Sarcoma

“…Four types of KS are described: classic (sporadic or Mediterranean), endemic (African), epidemic (or HIV-related), and iatrogenic (induced by immunosuppressive drugs) [1][2][3][4]. It mostly involves the skin (especially in distal limbs), but the KS extension to deeper structures such as bone and joints can be destructive and lead to severe functional impairment [5].…”