Before the AIDS epidemic, Kaposi sarcoma was seen mainly in elderly Italian and Jewish men, and rarely, in elderly women. Among this group, the tumors developed slowly. In AIDS patients, the cancer can develop quickly. It may also involve the:
- Gastrointestinal tract
- Other organs
In people with AIDS, Kaposi sarcoma is caused by an interaction between HIV, a weakened immune system, and the human herpesvirus-8 (HHV-8). Kaposi sarcoma has been linked to the spread of HIV and HHV-8 through sexual activity.
People who have kidney or other organ transplants are also at risk for Kaposi sarcoma.
African Kaposi sarcoma is fairly common in young adult males living near the equator. One form is also common in young African children.
The tumors (lesions) most often appear as bluish-red or purple bumps on the skin. They are reddish-purple because they are rich in blood vessels.
Exams and Tests
The following tests may be performed to diagnose Kaposi sarcoma:
How this condition is treated depends on:
- How much the immune system is suppressed (immunosuppression)
- Number and location of the tumors
- Antiviral therapy against HIV, since there is no specific therapy for HHV-8
- Combination chemotherapy
- Freezing the lesions
- Radiation therapy
Lesions may return after treatment.
Treating Kaposi sarcoma does not improve the chances of survival from AIDS itself. The outlook depends on the person's immune status and how much of the HIV virus is in their blood (viral load).
Complications can include:
- Cough (possibly bloody) and shortness of breath if the disease is in the lungs
- Leg swelling that may be painful or cause infections if the disease is in the lymph nodes of the legs
The tumors can return even after treatment. Kaposi sarcoma can be deadly for a person with AIDS.
An aggressive form of African Kaposi sarcoma can spread quickly to the bones. Another form found in African children does not affect the skin. Instead, it spreads through the lymph nodes and vital organs, and can quickly become deadly.
Safe sexual practices can prevent HIV infection. This prevents AIDS and its complications, including Kaposi sarcoma.
Kaye KM. Kaposi's sarcoma-associated herpesvirus (human herpesvirus type 8). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2014:chap 143.
Volberding PA. Hematology and oncology in patients with human immunodeficiency virus infection. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 400.
Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.