OPPORTUNISTIC INFECTIONS IN HIV
Kaposi’s sarcoma is a rare, multi-centric tumor of the endothelium (meaning it can develop at several areas of the body at once from the lining of blood vessels). It is caused by the Kaposi’s sarcoma herpes virus (KSHV), also called human herpes virus-8 (HHV-8). Most people that have the virus do not develop Kaposi’s sarcoma unless their immunity is compromised. There are several types, but the most common has links to advanced HIV.
- Infection with KSHV (from sex, mother to child transmission, saliva, blood transfusion, tissue or organ transplant)
- People on immune-suppressants
- Old age
- Purple, red or brown skin lumps, rashes, or ulcers
- Mouth ulcers
- Shortness of breath
- Swollen lymph nodes
- Blood in stool
- Vomiting blood
- Difficulty or pain on swallowing
TYPES OF KS
- Epidemic KS;
This is the most common and most aggressive type and usually occur in people with aids (stage 3 HIV). People with normal cd4 cell count and undetectable viral load however, can still occasionally develop KS. The lesions are usually multiple, often on the face and trunk.
- Classic KS;
This type is commonly found in older adults of eastern Europe, Mediterranean and middle east origin. Occurring in men more than women, the lesions occur mostly on skin of lower limbs, particularly at the ankles and soles of feet. this is the least aggressive type and rarely ever leads to internal tumors.
- Endemic KS;
This type is also called African KS. It was relatively common in equatorial Africa but is now the most common worldwide, due to high incidence of HIV in Africa. It is usually seen in the under 40 age group. It can have a mild course which affects the skin only, (like the classical type), or a more severe course involving the lymphatic system and internal organs.
- Iatrogenic KS;
Also called transplant related KS, it usually appears suddenly and usually have a mild course which can become severe sometimes.
Biopsy and histology is the gold standard, though more tests like endoscopy, bronchoscopy, ultra sound scan, etc. may be used to determine the extent of the lesions.
Anti-retroviral drugs are strongly recommended for those with HIV, and reduction of immune suppressants dosage might help those with iatrogenic type.
Specific treatment through; chemotherapy, radiotherapy, immunotherapy and local treatments (including surgery) may also be used.
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