Clinical aspects of HIV infection in women

Epidemic (human immunodeficiency virus‐related) Kaposi's sarcoma in West African women

“…Epidemic Kaposi's sarcoma commonly occurs in HIV‐positive individuals and is associated with homosexual behavior 3–7 . It is currently not an uncommon finding in Nigeria, because the cumulative number of HIV infections is increasing yearly.…”

“…Some clinicians suggested that lifestyle factors might be relevant to the development of Kaposi's sarcoma, 3,4 and the disproportionately high incidence of Kaposi's sarcoma in homosexual and bisexual men with AIDS led to speculation that, in addition to background HIV infection, a sexually transmitted agent might be responsible for epidemic Kaposi's sarcoma 3,4 . Subsequently, the detection of human herpesvirus 8 (HHV8) in the semen of men with Kaposi's sarcoma 3,5 supported this hypothesis.…”

“…Kaposi's sarcoma occurs less frequently in HIV‐infected women than in HIV‐infected men, 1–3 presumably because HHV8 is mainly transmitted through male homosexual behavior. In women with HIV who have a diagnosis of Kaposi's sarcoma, sexual contact with a bisexual male is believed to be the most frequent source of HIV infection 5 . Studies on the frequency of Kaposi's sarcoma in women with HIV have also strengthened the hypothesis of the sexual transmission of AIDS‐related Kaposi's sarcoma 3,6 .…”

“…Despite the lower prevalence of Kaposi's sarcoma in HIV‐infected women, the disease appears to run a more aggressive course in women than in men 5,6 . The impact of Kaposi's sarcoma on the quality of life is also far more pronounced for women, particularly for African women, who have severe limitations within their society.…”