Delayed diagnosis of Kaposi's sarcoma in a HIV positive man with a high CD4 count and suppressed viral load: Figure 1

Abstract

A HIV positive man with a CD4 count of 777×10(6)/l and suppressed viral load on antiretroviral medication had a delayed diagnosis of Kaposi's sarcoma (KS) affecting his left leg. He was diabetic and on a controlled diet and had a previous deep vein thrombosis affecting the same leg. Factors that have been studied in HIV-related KS as well as classical KS, such as diabetes mellitus, not smoking and previous deep vein thrombosis, may have increased our patient's risk for the development of this disease. Clinicians should consider KS as a possible diagnosis even in patients with well-controlled HIV.

Acroangiodermatitis mimicking Kaposi’s sarcoma in an HIV-positive man

“…Whilst occurring more commonly with late or advanced HIV disease, KS does still occurs in patients with CD4 cell counts above 500 cells/mm³. 1 We describe a case where clinical appearance was highly suggestive of KS, but an alternative diagnosis was considered and confirmed by histology and the absence of HHV-8 immunohistochemistry and serology.…”

The Role of Type 2 Diabetes for the Development of Pathogen-Associated Cancers in the Face of the HIV/AIDS Epidemic

“…This well-documented link of HIV infection, type 2 diabetes and liver cancer is less evident for other pathogen-associated malignancies. For example, only case reports on HIV-related KS in the presence of type 2 diabetes are currently available, calling attention to the risk of delayed diagnosis of KS in patients on ART with a relatively high CD4 count ( Chan and Pakianathan, 2011 ). Although no such case report on the link between HIV, type 2 diabetes and cervical cancer exists, an interesting recent study describes the combination of metformin, the worldwide most widely prescribed first-line therapeutic drug for type 2 diabetes and known for its antitumor properties ( Kasznicki et al, 2014 ), together with nelfinavir, an HIV protease inhibitor.…”

Highlights from this issue

“…We end with the interaction between education and HIV progression in a Spanish cohort,12 and missed diagnosis of Kaposi's sarcoma in a man with high CD4 count and low viral load 13…”