Kaposi's Sarcoma in South Africa

Sitas, Freddy; Newton, Robert

doi:10.1093/oxfordjournals.jncimonographs.a024250

Cited by 72 publications

(57 citation statements)

References 30 publications

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“…For example, between 1988 and 1996, the incidence of Kaposi's sarcoma has risen at least three-fold in South Africa and continues to increase as the HIV epidemic grows. Data from Johannesburg, South Africa, show that incidence rates of Kaposi's sarcoma have doubled in men, but have increased seven-fold in women, such that the sex ratio of 7 : 1 in males vs females in 1988 has now declined to only 2 : 1 (Sitas and Newton, 2000). The role of other cofactors in the aetiology of Kaposi's sarcoma may, therefore, be less relevant in the presence of HIV infection than they seem to have been for the development of classical Kaposi's sarcoma prior to the spread of HIV.…”

Section: Resultsmentioning

confidence: 99%

Review of the distribution of Kaposi's sarcoma-associated herpesvirus (KSHV) in Africa in relation to the incidence of Kaposi's sarcoma

2003

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In the years before human immunodeficiency virus (HIV) infection, the incidence of Kaposi's sarcoma varied markedly across the African continent, and it was a disease primarily affecting men. In contrast, the evidence reviewed here shows that the causal virusKaposi's sarcoma associated herpesvirus (KSHV) -is prevalent in many African countries, including places where Kaposi's sarcoma was almost unknown before HIV, and that it is as common in women as in men. Therefore, the geographical distribution of Kaposi's sarcoma in Africa before the spread of HIV and its predominance as a disease affecting men are not a simple reflection of the distribution of KSHV. Since the epidemic of HIV in Africa, Kaposi's sarcoma has become relatively more frequent in women, and the incidence has increased in countries where it was previously rare, but where KSHV is prevalent, as well as in countries where it was already common. These changes point to a role for other (as yet unknown) factors in the aetiology of Kaposi's sarcoma that may have the most effect in the absence of concurrent HIV infection.

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Section: Resultsmentioning

confidence: 99%

Review of the distribution of Kaposi's sarcoma-associated herpesvirus (KSHV) in Africa in relation to the incidence of Kaposi's sarcoma

2003

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“…However, the available number of patients does not currently permit the mounting of large clinical trials in KS without the cooperation of multiple institutions, and other agents have displaced IFN as a priority in multicenter clinical studies. It is also important to recognize that KS incidence is extremely high in sub-Saharan Africa [70][71][72] where HIV and KSHV infection rates are both much higher than in resource-rich parts of the world and where the availability of HIV treatments is limited. In such settings, however, the use of an injectable agent is impractical, although there remains a critical need for effective KS therapy.…”

Section: Changes In Ks Incidencementioning

confidence: 99%

AIDS-associated Kaposi's sarcoma: Is there still a role for interferon alfa?

Krown

2007

Cytokine & Growth Factor Reviews

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Interferon alfa (IFNA) was one of the first agents to be used therapeutically in AIDS-associated Kaposi's sarcoma (KS) more than 25 years ago, and induces tumor regression in a subset of patients. Although much has been learned about the clinical role of IFNα in KS treatment, little is currently known about the mechanism(s) by which IFNA causes KS regression. This is despite a growing understanding of both KS pathogenesis and relevant IFNA activities. To a large extent other agents have supplanted IFNA as treatments for KS, but there may still remain a therapeutic role for IFNA, possibly in combination with other agents targeting angiogenesis and/or HHV-8-encoded human gene homologs that encode proteins involved in cell cycle regulation and signaling. KeywordsInterferon; Kaposi's sarcoma In 1995, when I was honored as a recipient of the ISICR Milstein Award, the AIDS epidemic had recently begun its 15 th year and the human immunodeficiency virus (HIV-1) had been isolated some 12 years previously [1]. However, the virus associated with Kaposi's sarcoma (KS), the most common AIDS-associated malignancy, had been described less than a year earlier [2], its significance was still in some question and its role in KS development had not been characterized, and the active combination drug regimens with which we now treat HIV infection had not yet become widely available. Recombinant interferon alfa preparations (IFNα2a and IFNα2b), which had received approval from the U.S. Food and Drug Administration (FDA) for treatment of AIDS-associated KS in 1988, were still the only approved drugs for systemic treatment of KS (the chemotherapeutic agent, liposomal doxorubicin, would receive FDA approval later in 1995, as did liposomal daunorubicin in 1996 and paclitaxel in 1997). Now, more than a quarter century after the first published reports describing AIDS and its association with KS [3-6] and our first modestly successful attempts to treat KS with IFNα [7], this agent is used infrequently to treat KS, although it still finds use in HIV-infected individuals co-infected with hepatitis C. In this brief review, I will summarize some of the history of IFNα in the treatment of AIDS-associated KS, concentrating on examples of clinical trials in which I have personally been involved, and consider whether there remains a potentially valuable role for this agent in KS treatment.

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“…7 KS rarely affects American or European heterosexuals, but it often occurs in African or Caribbean heterosexuals. 8 Most patients with pulmonary KS already present with cutaneous lesions at the time of diagnosis; however, visceral disease may occasionally precede the skin. The most affected skin sites are the lower limbs, head and neck, and the lesions may have a varied appearance (spots, papules, nodules or plaques), all palpable and non-pruritic, with sizes ranging from millimeters to centimeters, and brownish, pink or violet color.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Kaposi’s sarcoma in a female patient: Case report

Petribu¹,

Cisneiros²,

Carvalho³

et al. 2016

Rev. Assoc. Med. Bras.

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SUMMARY Kaposi’s sarcoma (KS) is a multicentric lymphoproliferative malignancy. Most of the time this tumor is confined to the skin and subcutaneous tissue, but it can present with widespread visceral involvement, such as in the lung. Pulmonary KS is the most frequent form in young adult males, in a ratio of 15:1. The disease usually affects individuals with low CD4 lymphocyte counts (<150-200 cells/mm3). We report a case of a female patient aged 35 years, with the presence of skin lesions, self-limiting episodes of diarrhea and weight loss of 15 kg for nearly 9 months, progressing to persistent fever. AIDS was diagnosed and biopsy of the lesions revealed Kaposi’s sarcoma. Computed tomography of the chest showed peribronchovascular thickening, areas of ground glass opacity, condensations with air bronchograms surrounded by ground glass opacity (halo sign) and bilateral pleural effusion. The diagnosis of pulmonary KS is still a challenge, especially due to the occurrence of other opportunistic diseases that may also occur concurrently. Therefore, suspecting this diagnosis based on clinical and laboratory manifestations, and even more with CT findings, is fundamental, especially in patients who already have the cutaneous form of the disease.

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Kaposi's Sarcoma in South Africa

Cited by 72 publications

References 30 publications

Review of the distribution of Kaposi's sarcoma-associated herpesvirus (KSHV) in Africa in relation to the incidence of Kaposi's sarcoma

Review of the distribution of Kaposi's sarcoma-associated herpesvirus (KSHV) in Africa in relation to the incidence of Kaposi's sarcoma

AIDS-associated Kaposi's sarcoma: Is there still a role for interferon alfa?

Pulmonary Kaposi’s sarcoma in a female patient: Case report

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