Kaposi's sarcoma classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Classification

HHV-8 is responsible for all varieties of KS. Since Moritz Kaposi first described this malignant neoplasm, the disease has been reported in five separate clinical settings, with different presentations, epidemiology, and prognoses[1]:599. All of these forms are infected with KSHV and are different manifestations of the same disease but have differences in clinical aggressiveness, prognosis and treatment.

  1. Classic Kaposi sarcoma; as originally described was a relatively indolent disease affecting elderly men from the Mediterranean region, or of Eastern European descent. Countries bordering the Mediterranean basin have higher rates of KSHV/HHV-8 infection than the remainder of Europe [2][3]
  2. Endemic KS, which has two types, African cutaneous Kaposi sarcoma and African lymphadenopathic Kaposi sarcoma was described later in young African people, mainly from sub-Saharan Africa, as a more aggressive disease that infiltrated the skin extensively, especially on the lower limbs. This, it should be noted, is not related to HIV infection. KS is prevalent worldwide.[4][5]
  3. Immunosuppression-associated Kaposi sarcoma had been described, but only rarely until the advent of calcineurin inhibitors (such as ciclosporines, which are inhibitors of T-cell function) for transplant patients in the 1980s, when its incidence grew rapidly. The tumor arises either when an HHV 8-infected organ is transplanted into someone who has not been exposed to the virus or when the transplant recipient already harbors pre-existing HHV 8 infection.[6][7]
  4. AIDS-associated Kaposi sarcoma or Epidemic KS was described during the 1980s as an aggressive disease in AIDS patients (HIV also causes a defect in T-cell immunity). It is over 300 times more common in AIDS patients than in renal transplant recipients. In this case, HHV 8 is sexually transmitted among people also at risk for sexually transmitted HIV infection.[8]

References

  1. James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
  2. Iscovich, J; Boffetta, P; Winkelmann, R; Brennan, P; Azizi, E (1998). "Classic Kaposi's sarcoma in Jews living in Israel, 1961-1989: a population-based incidence study". AIDS. 12 (15): 2067–72. doi:10.1097/00002030-199815000-00019. PMID 9814876. Unknown parameter |month= ignored (help)
  3. Fenig, E; Brenner, B; Rakowsky, E; Lapidoth, M; Katz, A; Sulkes, A (1998). "Classic Kaposi sarcoma: experience at Rabin Medical Center in Israel". Am J Clin Oncol. 21 (5): 498–500. doi:10.1097/00000421-199810000-00016. PMID 9781608. Unknown parameter |month= ignored (help)
  4. Cook-Mozaffari, P; Newton, R; Beral, V; Burkitt, DP (1998). "The geographical distribution of Kaposi's sarcoma and of lymphomas in Africa before the AIDS epidemic". Br J Cancer. 78 (11): 1521–8. doi:10.1038/bjc.1998.717. PMC 2063225. PMID 9836488. Unknown parameter |month= ignored (help)
  5. Olsen, SJ; Chang, Y; Moore, PS; Biggar, RJ; Melbye, M (1998). "Increasing Kaposi's sarcoma-associated herpesvirus seroprevalence with age in a highly Kaposi's sarcoma endemic region, Zambia in 1985". AIDS (PDF)|format= requires |url= (help). 12 (14): 1921–5. doi:10.1097/00002030-199814000-00024. PMID 9792393. Unknown parameter |month= ignored (help)
  6. Qunibi, W; Al-Furayh, O; Almeshari, K; Lin, SF; Sun, R; Heston, L; Ross, D; Rigsby, M; Miller, G (1998). "Serologic association of human herpesvirus eight with posttransplant Kaposi's sarcoma in Saudi Arabia". Transplantation. 65 (4): 583–5. doi:10.1097/00007890-199802270-00024. PMID 9500639. Unknown parameter |month= ignored (help)
  7. Luppi, Mario; Barozzi, P; Schulz, TF; Setti, G; Staskus, K; Trovato, R; Narni, F; Donelli, A; Maiorana, A (2000). "Bone marrow failure associated with human herpesvirus 8 infection after transplantation". N Engl J Med. 343 (19): 1378–85. doi:10.1056/NEJM200011093431905. PMID 11070102. Unknown parameter |month= ignored (help)
  8. Beral V, Peterman TA, Berkelman RL, Jaffe HW (1990). "Kaposi's sarcoma among persons with AIDS: a sexually transmitted infection?". Lancet. 335 (8682): 123–8. doi:10.1016/0140-6736(90)90001-L. PMID 1967430. Unknown parameter |month= ignored (help)

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