Kaposi sarcoma is a disease of blood vessels that was considered very rare before the start of the AIDS pandemic. AIDS is due to infection with human immunodeficiency virus (HIV).
There are four types of Kaposi sarcoma:
- The classic type of Kaposi sarcoma affects elderly men of Mediterranean and Middle European descent and in men in Sub-Saharan Africa.
- HIV-associated Kaposi sarcoma mainly affects men who have sex with men.
- Endemic or African Kaposi sarcoma arises in some parts of Africa in children and young adults.
- Iatrogenic Kaposi sarcoma is due to drug treatment causing immune suppression.
Classic Kaposi sarcoma is rare and unassociated with HIV infection. It most often arises in middle-aged to elderly men of Mediterranean or Jewis descent (less than 10% are women), particularly if they come from a rural environment. They have a higher than expected rate of diabetes mellitus.
In the United States, Kaposi sarcoma was particularly common in the 1980s especially amongst HIV-positive men who had sex with men. It occurs less frequently in intravenous drug users and is rare in women, haemophiliacs or their sexual partners. HIV-associated Kaposi sarcoma is more common in women in some parts of Africa. It has become less common in the US and Europe because of effective HAART treatment for HIV disease.
African Kaposi sarcoma is becoming more prevalent with the rise in HIV infection. It is one of the most common forms of cancer, especially in children, in Uganda and Zambia.
Iatrogenic Kaposi sarcoma is a particular concern for organ transplant patients, especially in geographic areas associated with high levels of infection with KSHV. Most have the virus prior to transplantation, but the drugs causes it to reactivate.
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