Kaposi’s Sarcoma
Kaposi’s sarcoma is a malignant tumor of the connective tissue, often associated with AIDS.
Kaposi’s sarcoma (KS) was described initially in 1872 by a Hungarian dermatologist, Moritz Kaposi. Before AIDS epidemic, KS was considered a rare disease that mostly affected elderly men of Mediterranean or Jewish heritage, organ transplant patients, or young adult African men. Now, most KS cases have developed in association with human immunodeficiency virus (HIV) infection and the acquired immunodeficiency syndrome (AIDS). KS occurs in patients with advanced HIV infection. In the United States, KS serves as an AIDS-defining illness in 10-15% of HIV-infected homosexual men.The first sign of KS is usually the development of red, brown, purple or even black small tumors on the skin. They are usually painless, but inflammation around the tumor may produce swelling and pain. These can be anywhere, but most often are on the feet, ankles, thighs, arms, hands and face.
Although KS may be suspected from the appearance of lesions and the patient’s risk factors, a definite diagnosis can only be made by biopsy and microscopic examination.
Unusual for a type of cancer, but we know what the cause of Kaposi’s sarcoma is: a virus called Human Herpes Virus 8 which is also known as Kaposi’s Sarcoma-associated Herpes Virus. It can affect people with a weakened immune system, including people with HIV and AIDS. HHV8 is mainly spread through saliva, but can also be spread in blood and semen, or from a mother to her unborn child. The virus can be passed on through sexual contact, kissing, blood transfusions and organ transplantation.
Unfortunately, Kaposi’s sarcoma is not curable, but it can often be effectively palliated for many years and this is the aim of treatment. In 40% or more of patients with AIDS-associated Kaposi’s sarcoma, the Kaposi lesions will shrink upon first starting highly active antiretroviral therapy. The most widely used and effective local therapy is radiotherapy. More widespread disease, or disease affecting internal organs, is generally treated with systemic therapy with interferon alpha, or paclitaxel.
In US there are quite a few clinical trials for Kaposi’s sarcoma in HIV positive patients as well as in HIV negative patients. I strongly recommend people with KS to get information about them because they might get the best treatment available for their disease.
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