• Clinical manifestations of classical, endemic African, and epidemic AIDS-associated Kaposi's sarcoma.

• Recent developments in sexually transmitted diseases: is Kaposi's sarcoma a sexually transmitted disease?

• The epidemiology of classic, African, and immunosuppressed Kaposi's sarcoma.

• Epidemiology of Kaposi's sarcoma.

• Changes in survival after acquired immunodeficiency syndrome (AIDS): 1984-1991.

• AIDS-associated Kaposi's sarcoma in an Indian female.

• Malignant lymphoma presenting as Kaposi's sarcoma in a homosexual man with the acquired immunodeficiency syndrome.

• The natural history of Kaposi's sarcoma in the acquired immunodeficiency syndrome.

• Disease manifestation among homosexual men with acquired immunodeficiency syndrome: a possible role of nitrites in Kaposi's

• Kaposi's sarcoma and HTLV-III: a study in Nigerian adult males.

• Lymphadenopathic type of Kaposi's sarcoma in a Ugandan child seropositive for LAV/HTLV-III antibodies.

• Opportunistic infections and Kaposi's sarcoma among Haitians: evidence of a new acquired immunodeficiency state.

• Changing patterns of Kaposi's sarcoma in N.E. Zaire.

• Malignancies in the AIDS patient: natural history, treatment strategies, and preliminary results.

• Pathogenetic role of HIV infection in Kaposi's sarcoma of equatorial East Africa.

• Clinical and histopathological aspects of Kaposi's sarcoma in Africa: relationship with HIV serology.

• Declines in proportion of Kaposi's sarcoma among cases of AIDS in multiple risk groups in New York City.

• Lympho-cutaneous Kaposi's sarcoma in an African pediatric AIDS case.

• Neopterin and alpha-interferon in patients affected by Kaposi's sarcoma from Africa.

• Radiation therapy in epidemic, AIDS-related Kaposi's sarcoma in southern Africa.

• Kaposi's sarcoma and AIDS in Uganda: its frequency and gastrointestinal distribution.

• Epidemic AIDS-related Kaposi's sarcoma in southern Africa: experience at the Johannesburg General Hospital (1980-1990).

• A role for a new herpes virus (KSHV) in different forms of Kaposi's sarcoma.

• Chemotherapy for AIDS-related and endemic African Kaposi's sarcoma in southern Africa.

• Kaposi's sarcoma in childhood: an analysis of 100 cases from Uganda and relationship to HIV infection.

• Detection and sequence analysis of a new herpesvirus-like agent in AIDS and non-AIDS Kaposi's sarcoma in Taiwan.

• The importance of clinical features in differentiating HIV related from non-HIV related Kaposi's sarcoma: experience from Dar es Salaam,

• Risk factors for Kaposi's sarcoma in HIV-positive subjects in Uganda.

• [Recommendations of GESIDA/Spanish National Plan of AIDS on diagnosis and treatment of Kaposi's sarcoma and cervical cancer in HIV-infected

• A case-control study of HIV-1-related dementia and co-infection with HHV-8.

• Primary effect of chemotherapy on the transcription profile of AIDS-related Kaposi's sarcoma.

• [AIDS in Naples in 1800. 12 cases of Kaposi sarcoma described by Tommaso de Amicis]

1
UI - 2193952
AU - Friedman-Kien AE; Saltzman BR
TI - Clinical manifestations of classical, endemic African, and epidemic AIDS-associated Kaposi's sarcoma.
SO - J Am Acad Dermatol 1990 Jun;22(6 Pt 2):1237-50
AD - Department of Dermatology and Microbiology, New York University Medical Center, NY 10016.
Kaposi's sarcoma, first described in 1972, is a rare, chronic neoplasm that occurs most often in elderly men of Eastern European origin. In the mid-twentieth century, more aggressive forms of Kaposi's sarcoma were found to be an endemic disease especially common among young black men in central Africa. Kaposi's sarcoma also occurs in iatrogenically immunosuppressed patients, such as kidney transplant recipients. In 1981, the sudden occurrence of an unusual, disseminated form of Kaposi's sarcoma in homosexual men in New York and California heralded the epidemic now known as the acquired immunodeficiency syndrome (AIDS). Ninety-five percent of all AIDS-associated Kaposi's sarcoma (AIDS-KS) has been in homosexual men; however, the incidence of AIDS-KS has diminished from greater than 40% of men with AIDS since 1981 to less than 20% in 1989. The remaining 5% of AIDS-KS has been seen in all other populations at risk for AIDS. The reasons for the remarkable persistent increased prevalence of AIDS-KS among homosexual men remains obscure. Clinically, AIDS-KS is a highly varied neoplastic disease characterized by multifocal mucocutaneous lesions often with lymphatic and visceral involvement. The etiology of Kaposi's sarcoma remains unknown although various hypotheses have been suggested, including endothelial-tumor growth factors, oncogenic expression, genetic predisposition, and environmental cofactors. An as-yet unidentified viruslike agent has been proposed as a possible direct cause of this neoplasm. Different treatment modalities for Kaposi's sarcoma have been employed with varying success, these include localized radiation therapy, cryotherapy, electrocauterization, surgical excision, and a variety of systemic chemotherapeutic regimens, as well as alpha-interferon. Although all available treatments help control the lesions, none lengthens survival.

2
UI - 2261787
AU - Felman YM
TI - Recent developments in sexually transmitted diseases: is Kaposi's sarcoma a sexually transmitted disease?
SO - Cutis 1990 Oct;46(4):303-6
AD - Downstate Medical School, New York.

3
UI - 1765111
AU - Wahman A; Melnick SL; Rhame FS; Potter JD
TI - The epidemiology of classic, African, and immunosuppressed Kaposi's sarcoma.
SO - Epidemiol Rev 1991;13():178-99
AD - Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55454-1015.
The etiology of Kaposi's sarcoma remains somewhat obscure. While lesions of classic Kaposi's sarcoma, African Kaposi's sarcoma, and immunosuppressed Kaposi's sarcoma have been found to be indistinguishable from one another, the reasons for the variations in type and severity have not been established. The origin of the spindle cell is yet to be agreed on. Geographic variation does not seem as important as ethnic variation. The very young and the very old, perhaps two ages of weakened immunity, tend to have a higher incidence of Kaposi's sarcoma. Children and AIDS patients tend to develop more virulent disease. Males tend to get Kaposi's sarcoma at higher rates than do females. Jewish and Mediterranean males have the highest incidence of classic Kaposi's sarcoma, and African Bantu have the highest incidence of African Kaposi's sarcoma, classifications which do not apply to the Kaposi's sarcoma population in the United States. Male homosexuals have much higher incidence of Kaposi's sarcoma than do male heterosexuals, but since the early 1980s, its incidence as the presenting manifestation of AIDS has decreased dramatically. There is no unequivocal association with HLA haplotype (though DR5 carriers may be at especially high risk) or evidence of family clustering. There is an impressive but not always consistent association between Kaposi's sarcoma development and immunodeficiency. Environmental factors, such as nitrite use, immunosuppression, and repeated cytomegalovirus infection, are associated with Kaposi's sarcoma, but the exact mechanism is unclear and the associations remain inconsistent. Finally, it is still unclear if there is a causative infectious agent for Kaposi's sarcoma. While cytomegalovirus has been linked to Kaposi's sarcoma, there are weaknesses in its hypothetical role as an etiologic agent as is the case for HIV itself.(ABSTRACT TRUNCATED AT 400 WORDS)

4
UI - 1821323
AU - Beral V
TI - Epidemiology of Kaposi's sarcoma.
SO - Cancer Surv 1991;10():5-22
AD - ICRF Cancer Epidemiology Unit, Radcliffe Infirmary, Oxford.
The AIDS epidemic drew attention to KS, a previously rare and little studied condition. The epidemiological evidence summarized here strongly suggests that the disease is caused by a transmissible agent, in addition to HIV. Sexual contact is the most important mode of transmission of the agent, although transmission by blood and perinatally may also occur (Beral et al, 1990).

5
UI - 7903022
AU - Jacobson LP; Kirby AJ; Polk S; Phair JP; Besley DR; Saah AJ; Kingsley
TI - LA; Schrager LK Changes in survival after acquired immunodeficiency syndrome (AIDS): 1984-1991.
SO - Am J Epidemiol 1993 Dec 1;138(11):952-64
AD - Johns Hopkins University, School of Public Health, Department of Epidemiology, Baltimore, MD 21205.
In a prospective cohort of 2,647 human immunodeficiency virus type 1 (HIV-1) seropositive homosexual men enrolled in Baltimore, Chicago, Los Angeles, and Pittsburgh, 891 developed clinical acquired proportional hazards models were used to examine temporal trends in survival after AIDS for specific diagnoses, controlling for level of immunosuppression at diagnosis, age, race, and geographic location. Median survival time following AIDS onset increased from 11.6 months in 1984-1985 to 19.5 months in 1988-1989; for those diagnosed in 1990-1991, the median survival time dropped to 17.2 months. Trends in improved survival were diagnosis-specific. Survival after Pneumocystis carinii pneumonia consistently improved from 1984 to 1991 (p < 0.001). Compared with men diagnosed in 1984-1985, those diagnosed with P. carinii pneumonia in 1990-1991 had one-tenth the hazard of dying. For men with > or = 100 helper T-lymphocytes (CD4+ cells) when diagnosed with Kaposi's sarcoma, the relative hazards (95% confidence intervals) of dying after Kaposi's sarcoma were 0.8 (0.42-1.60) in 1986-1987, 0.7 (0.34-1.58) in 1988-1989, and 0.6 (0.19-1.61) in 1990-1991 compared with those diagnosed before 1986. Men with < 100 CD4+ cells when diagnosed with Kaposi's sarcoma did not demonstrate a consistent change in their subsequent survival. After a nonsignificant (p > 0.05) initial improvement in prognosis, there has not been a significant improvement in survival for men who presented with other opportunistic infections. Observed increases in overall survival probably relate to improved treatment of patients who develop P. carinii pneumonia. Limited improvement in survival following other AIDS diagnoses indicates the need for developing effective treatment against these diseases.

6
UI - 8270582
AU - Shroff HJ; Dashatwar DR; Deshpande RP; Waigmann HR
TI - AIDS-associated Kaposi's sarcoma in an Indian female.
SO - J Assoc Physicians India 1993 Apr;41(4):241-2
AD - Department of Dermatology & STD, Grant Medical College, Bombay.
We report the first case of AIDS-associated Kaposi's Sarcoma in a 35 year old Indian female, a commercial sex worker, with lesions involving skin and mucous membranes. Diagnosis was confirmed on histopathology, electron microscopy, seropositivity, (ELISA and Western Blot) as well as Pepti-LAV test and viral culture. Antibodies to human immunodeficiency virus, both HIV-1 & 2, were present. HLA DR5,7 was positive on oligotyping. Genetic predisposition, therefore, may be suspected.

7
UI - 2982306
AU - Lind SE; Gross PL; Andiman WA; Stone GC; Schooley RT; Harris NL
TI - Malignant lymphoma presenting as Kaposi's sarcoma in a homosexual man with the acquired immunodeficiency syndrome.
SO - Ann Intern Med 1985 Mar;102(3):338-40
A homosexual man had Kaposi's sarcoma of the skin and lymph nodes. After a brief response to interferon, the patient developed new skin lesions. Massive bleeding in the gastrointestinal tract prompted endoscopy, which showed tumor involvement of the stomach, believed to be Kaposi's sarcoma. At autopsy, a diffuse lymphoma was found involving the skin and gastrointestinal tract, forming collision tumors in regions that contained Kaposi's sarcoma. Lymphomatous tissue, but not uninvolved lymph node or spleen, contained Epstein-Barr virus DNA, as shown by DNA hybridization studies. Epstein-Barr virus may play a role in the development of lymphoma in immunosuppressed patients. Unusual manifestations of tumors, such as the massive gastrointestinal bleeding seen in this case, may indicate the development of a second neoplasm.

8
UI - 3901851
AU - Safai B; Johnson KG; Myskowski PL; Koziner B; Yang SY;
TI - Cunningham-Rundles S; Godbold JH; Dupont B The natural history of Kaposi's sarcoma in the acquired immunodeficiency syndrome.
SO - Ann Intern Med 1985 Nov;103(5):744-50
Kaposi's sarcoma is a multifocal systemic neoplasm histologically characterized by proliferating fibroblastic and microvascular elements. Initial signs include macules, papules, or nodules on the skin or mucosal surface. Lesions are frequently found on the trunk, arms, and head and neck. In general, sites of involvement and tumor load do not correlate with prognosis. A general decrease in the functional capacities of T and B cells is found in most patients. Kaposi's sarcoma is reported as the initial manifestation of the acquired immunodeficiency syndrome (AIDS) in approximately 30% of cases. Most cases are in men, although it has been reported in all risk groups. Kaposi's sarcoma in AIDS is more frequent among whites and homosexuals than blacks and intravenous drug abusers. Overall mortality is approximately 41%, with over 60% of patients alive at 1 year and 50% at 22 months. Overall survival is 18 months; however, some patients who have had the disease for 3 to 4 years are still doing well.

9
UI - 3878602
AU - Haverkos HW; Pinsky PF; Drotman DP; Bregman DJ
TI - Disease manifestation among homosexual men with acquired immunodeficiency syndrome: a possible role of nitrites in Kaposi's sarcoma.
SO - Sex Transm Dis 1985 Oct-Dec;12(4):203-8
To identify risk factors that determine the major manifestations of the acquired immunodeficiency syndrome (AIDS), the authors analyzed data from three epidemiologic studies conducted by the Centers for Disease Control. The authors compared patients by outcome of disease. Eighty-seven homosexual patients (47 with Kaposi's sarcoma, 20 with Pneumocystis carinii pneumonia, and 20 with both) had participated in the earlier studies, and their interviews and laboratory test results were available. Compared with patients who have Pneumocystis carinii pneumonia only, patients with Kaposi's sarcoma and those with both diseases reported more different sexual partners, more recreational drug use, higher incomes and higher rates of non-B hepatitis. Multivariate analysis showed that the variable most strongly associated with Kaposi's sarcoma was the use of large quantities of nitrite inhalants. A multifactorial model is postulated to explain the various disease manifestations of AIDS. This study suggests that the use of nitrite inhalants may be a cofactor in the development of Kaposi's sarcoma. By identifying other cofactors, investigators may be able to define additional opportunities for prevention of the development of AIDS.

10
UI - 3021963
AU - Otu AA
TI - Kaposi's sarcoma and HTLV-III: a study in Nigerian adult males.
SO - J R Soc Med 1986 Sep;79(9):510-4
Sera from 37 adult Nigerian men with Kaposi's sarcoma (KS), 30 contemporaneous controls bearing primary cell carcinoma of the liver (PCL), and 150 healthy non-tumour-bearing negative controls were tested for antibody to human T-cell lymphotropic virus type III/lymphadenopathy associated virus (HTLV-III/LAV) by enzyme-linked immunosorbent assays (ELISA). Certain immunocellular functions were also measured: the chemotactic locomotion of peripheral blood monocytes towards casein, delayed-type cutaneous hypersensitivity reaction to tuberculoprotein and opportunistic infection with the fungus Candida albicans. Sera from all these groups were also tested for markers of previous infections with the viruses cytomegalovirus (CMV), Epstein-Barr virus (EBV), hepatitis B (HBV) and hepatitis A (HAV). All serum samples tested were reproducibly and consistently negative for anti-HTLV-III/LAV. Peripheral blood monocytes from both KS and PCL patients showed profound depression of chemotaxis; similarly all tumour patients gave markedly depressed cutaneous reactivity to tuberculoprotein and uniformly exhibited seropositivity to CMV, EBV, HBV and HAV. A great majority showed evidence of infection with Candida albicans. It is concluded that tropical African KS is not associated with HTLV-III/LAV infection.

11
UI - 3470530
AU - Marquart KH; Muller HA; Hartter P; Oku JC; Ayuko WO
TI - Lymphadenopathic type of Kaposi's sarcoma in a Ugandan child seropositive for LAV/HTLV-III antibodies.
SO - J Trop Med Hyg 1987 Apr;90(2):93-4
The authors report a case of a lymphadenopathic type of Kaposi's sarcoma in a Ugandan boy aged 2 years and 1 month who was seropositive for antibodies to lymphadenopathy-associated virus/human T-lymphotropic virus type III (LAV/HTLV-III).

12
UI - 6299151
AU - Pitchenik AE; Fischl MA; Dickinson GM; Becker DM; Fournier AM; O'Connell
TI - MT; Colton RM; Spira TJ Opportunistic infections and Kaposi's sarcoma among Haitians: evidence of a new acquired immunodeficiency state.
SO - Ann Intern Med 1983 Mar;98(3):277-84 had Pneumocystis carinii pneumonia, central nervous system toxoplasmosis, esophageal candidiasis, cryptococcosis, disseminated cytomegalovirus, progressive herpes simplex virus, chronic enteric coccidiosis, or invasive Kaposi's sarcoma. Ten patients died. Opportunistic infections were frequently multiple and were recurrent in three patients. In seven patients disseminated tuberculosis preceded the other infections by 2 to 15 months. There was no evidence of an underlying immunosuppressive disease, and no history of homosexuality or intravenous drug abuse. At least three patients probably acquired the syndrome in Haiti. Lymphadenopathy was common. Seventeen patients tested had anergy, and 18 had lymphopenia. Monoclonal antibody analysis of peripheral-blood T-cell subsets done on 11 patients showed a marked decrease in T-helper cells and an inversion of the normal ratio of T-helper cells to T-suppressor cells. This syndrome among heterosexual Haitians is strikingly similar to the syndrome of immunodeficiency described recently among American homosexuals.

13
UI - 3603645
AU - Coker R; Wood PB
TI - Changing patterns of Kaposi's sarcoma in N.E. Zaire.
SO - Trans R Soc Trop Med Hyg 1986;80(6):965-6
A minor change in the pattern of Kaposi's sarcoma has been noticed in north-east Zaire. This is characterized by a small increase of the number of confirmed diagnoses, together with the appearance of the disease amongst women, who tend to be of a younger age group. These data suggests the appearance of a new aetiological factor in the area. From recent reports from other parts of Africa we speculate that this might be the appearance of HTLV-III virus.

14
UI - 6598311
AU - Longo DL; Steis RG; Lane HC; Lotze MT; Rosenberg SA; Preble O; Masur H;
TI - Rook AH; Fauci AS; Jacob J; et al Malignancies in the AIDS patient: natural history, treatment strategies, and preliminary results.
SO - Ann N Y Acad Sci 1984;437():421-30

15
UI - 3257865
AU - Craighead J; Moore A; Grossman H; Ershler W; Frattini U; Saxinger C;
TI - Hess U; Ngowi F Pathogenetic role of HIV infection in Kaposi's sarcoma of equatorial East Africa.
SO - Arch Pathol Lab Med 1988 Mar;112(3):259-65
AD - Department of Pathology, University of Vermont, Burlington 05405.
Thirty residents of north-central Tanzania with various forms of Kaposi's sarcoma (KS) were evaluated. The absolute number of peripheral blood OKT4 lymphocytes in patients and Tanzanian control subjects tended to be low (in comparison with healthy young American adults), and many had inverted T4/T8 ratios. Plasma polyclonal beta- and gamma-globulin concentrations were increased in many patients with KS and in control patients in Tanzania with chronic dermatopathies, but not in African hospital employees and patients undergoing elective surgery. Three of nine patients with locally aggressive KS possessed antibodies to human T-cell lymphotropic virus type III/lyphadenopathy-associated virus (HIV), but none had evidence of the acquired immunodeficiency syndrome (AIDS) or the AIDS-related complex. Three patients with disseminated, rapidly progressive KS and high HIV-antibody titers had an immunologic and clinical picture consistent with AIDS. Two of 13 patients with the classic plaque/nodular form of KS had low plasma titers of HIV antibody, but the significance of these serologic findings is not known. The evidence suggests that HIV plays a role in the pathogenesis of some cases of KS in East Africa, but most patients with KS in East Africa have no evidence of overt immunologic deficiency or HIV infection.

16
UI - 2905140
AU - Lesbordes JL; Martin PM; Ravisse P; Georges-Courbot MC; Georges AJ
TI - Clinical and histopathological aspects of Kaposi's sarcoma in Africa: relationship with HIV serology.
SO - Ann Inst Pasteur Virol 1988 Apr-Jun;139(2):197-203
AD - Centre National Hospitalier et Universitaire, Bangui (Republique Centrafricaine).
From 1983 to 1987, 45 Kaposi's sarcomas (KS) were diagnosed at the University Hospital in Bangui; 37 cases were easily classified as either endemic or AIDS-related KS on clinical grounds and HIV serology. Moreover, probably due to the stage at which patients consulted and lesions were sampled, noticeable histopathological differences were observed between the two clinical presentations. But for 8/45 which we classified as "borderline KS", strong discrepancies occurred between clinical aspects, patient evolution, HIV serology and histopathology. In two cases, HIV-positive patients had typical endemic non-evolutive KS and have survived 15 and 36 months.

17
UI - 2889930
AU - Des Jarlais DC; Stoneburner R; Thomas P; Friedman SR
TI - Declines in proportion of Kaposi's sarcoma among cases of AIDS in multiple risk groups in New York City.
SO - Lancet 1987 Oct 31;2(8566):1024-5

18
UI - 2929857
AU - Bouquety JC; Siopathis MR; Ravisse PR; Lagarde N; Georges-Courbot MC;
TI - Georges AJ Lympho-cutaneous Kaposi's sarcoma in an African pediatric AIDS case.
SO - Am J Trop Med Hyg 1989 Mar;40(3):323-5
AD - Department of Pediatrics, CHNU, Bangui, Central African Republic.
A case of disseminated Kaposi's sarcoma with lymphoid and mucocutaneous involvement in an African infant with acquired immune deficiency syndrome is reported. The child died within 2 months after recognition.

19
UI - 2767104
AU - Marfella A; Ruocco V; Capobianco A; Perna M; Santelli G; Frigione G;
TI - Kyalwazi SK; Mugerwa RD; Serwadda D; Beth-Giraldo E; et al Neopterin and alpha-interferon in patients affected by Kaposi's sarcoma from Africa.
SO - Eur J Cancer Clin Oncol 1989 Aug;25(8):1145-50
AD - Laboratory of Clinical Pathology, National Cancer Institute Fondaz. Sen. G. Pascale, Naples, Italy.
The presence of circulating alpha-interferon and neopterin was investigated in sera of 47 patients affected by African Kaposi's sarcoma, both HIV-seropositive (13 patients) and HIV-seronegative (34 patients). For comparison, analyses were also performed in 20 HIV-seropositive symptomatic African subjects as well as in 20 African and 20 Italian healthy individuals. Alpha-interferon and neopterin levels appeared significantly higher in comparison with healthy control groups (P less than 0.001) but not with HIV-seropositve African individuals without Kaposi's sarcoma. Moreover, alpha-interferon and neopterin levels were significantly higher in progressive Kaposi's sarcoma (27 patients) than in regressive Kaposi's sarcoma (20 patients) (P less than 0.001). A significant correlation between alpha-interferon and neopterin was observed (r = 0.57; P less than 0.01). Furthermore, alpha-interferon levels of HIV-seropositive Kaposi's sarcoma patients resulted significantly higher in comparison with the seronegative ones (P less than 0.05). It is concluded that alpha-interferon and neopterin may be reliable prognostic markers in Kaposi's sarcoma patients.

20
UI - 7519802
AU - Stein M; Spencer D; Kantor A; Lakier R; Lachter J; Ben-Yosef R; Bezwoda
TI - WR Radiation therapy in epidemic, AIDS-related Kaposi's sarcoma in southern Africa.
SO - Tumori 1994 Jun 30;80(3):216-9
AD - Department of Medical Oncology & Hematology, University of the Witwatersrand, RSA.
AIMS AND BACKGROUND: Acquired Immunodeficiency Syndrome (AIDS) associated Kaposi's Sarcoma (EKS) is widely spread in the Southern African Region. No large studies concerning the role of radiation therapy in the Southern African variant of EKS have been reported to date. METHODS: Over a 10 year period (1982-1992) 25 patients with EKS (disseminated skin involvement) were treated primarily with radiation therapy at the Johannesburg General Hospital. Radiation fields were individually tailored to the extent of the disease. Total administered doses ranged between 8-12 Gy (single fraction) to 24-30 Gy fractionated over 2-3 weeks. RESULTS: Overall response and symptomatic relief rates were 72% and 80%, respectively. Toxicity was mild and manageable. CONCLUSIONS: Our retrospective analysis supports the use of radiation therapy for the Southern African type of EKS.

21
UI - 7812024
AU - Ravera M; Reggiori A; Cocozza E; Andreata M; Ciantia F
TI - Kaposi's sarcoma and AIDS in Uganda: its frequency and gastrointestinal distribution.
SO - Ital J Gastroenterol 1994 Sep;26(7):329-33
AD - Hoima Hospital, Italian Cooperation, Kampala, Uganda.
The frequency and distribution of gastrointestinal Kaposi's sarcoma were investigated in 63 consecutive AIDS patients. The main risk factor for AIDS was heterosexual intercourse. Gastrointestinal lesions were found in 24 cases (38.1%): 12 patients (11.1%) had both upper and lower GI tract involvement, 7 patients (11.1%) had only oesophago-gastroduodenal lesions and 5 (7.9%) only lower tract disease. Our results show that in heterosexual Africans, the tumours closely resemble the tumours of western homosexuals in endoscopic appearance, in being multicentric and in the gastro-intestinal tract involved. We conclude that even in the heterosexual African AIDS population, the gastrointestinal tract is frequently involved and this phenomenon, if more widely studied might give us new elements about the aetiophatogenesis of Kaposi's sarcoma which is still unclear.

22
UI - 7570833
AU - Stein ME; Spencer D; Kantor A; Ruff P; Haim N; Bezwoda WR
TI - Epidemic AIDS-related Kaposi's sarcoma in southern Africa: experience at the Johannesburg General Hospital (1980-1990).
SO - Trans R Soc Trop Med Hyg 1994 Jul-Aug;88(4):434-6
AD - Department of Medical Oncology, Johannesburg General Hospital, Republic of South Africa.
Epidemic acquired immune deficiency syndrome-related Kaposi's sarcoma (AKS) in tropical and southern Africa is a highly varied neoplastic disease, characterized by multifocal mucocutaneous, lymphatic and visceral involvement. It follows a clinical course similar to AKS in Europe and the USA. However, lack of adequate medical facilities in many African countries hampers successful palliation of this fatal disease. In this retrospective analysis, we summarize our experience with 52 patients with AKS treated at Johannesburg General Hospital, South Africa, between 1980 and 1990. Radiation therapy can provide good to excellent palliation with only minimal side-effects, producing a lesser impact on the haematological and immunological system than chemotherapy.

23
UI - 7585156
AU - Schalling M; Ekman M; Kaaya EE; Linde A; Biberfeld P
TI - A role for a new herpes virus (KSHV) in different forms of Kaposi's sarcoma.
SO - Nat Med 1995 Jul;1(7):707-8
AD - Department of Molecular Medicine, Karolinska Institute and Hospital, Stockholm, Sweden.
Kaposi's sarcoma (KS) is a previously rare, tumour-like lesion of controversial biological nature. KS has since the early 1980s become frequent in patients with AIDS, particularly in homosexuals. KS is also endemic in Central Africa predominantly in otherwise healthy men but also in women and children. Recently, evidence for the presence of novel, herpes virus DNA sequences in more than 90% of AIDS Kaposi lesions (AKS) was presented. This DNA was identified using representational difference analysis (RDA) generating short, unique sequences with variable homology to several herpes virus, but no intact virus was recovered. If these DNA-sequences are also present in other, non-HIV-associated forms of Kaposi's sarcoma this would strongly suggest a specific, aetiopathological involvement of this putative new herpes virus in the pathogenesis of Kaposi's sarcoma, rather than a contamination of yet another opportunistic virus in immunosuppressed AIDS patients.

24
UI - 8537166
AU - Stein ME; Lachter J; Spencer D; Bezwoda WR
TI - Chemotherapy for AIDS-related and endemic African Kaposi's sarcoma in southern Africa.
SO - Int J Dermatol 1995 Oct;34(10):729-32
AD - Northern Israel Oncology Center, Rambam Medical Center, Haifa, Israel.
BACKGROUND. Kaposi's sarcoma (KS), either in its endemic (African) form or its AIDS-related variant, is a common neoplastic disorder seen in Southern Africa. Chemotherapy has been proven to be very effective in advanced or relapsed African Kaposi's sarcoma, but much less so in AIDS-related, endemic KS. PATIENTS AND METHODS. The study consists of a retrospective analysis of the results of chemotherapy alone in 17 patients with African KS (AKS) and in 32 patients with epidemic AIDS-related KS (EKS), treated at the Johannesburg General Hospital between 1982 and 1992. Single agents included vinblastine, actinomycin D, bleomycin, and vincristine; combined regimens were largely doxorubicin/vincristine/bleomycin or etoposide/methotrexate. Outcome classifications were: complete remission (CR), partial remission (PR), and treatment failure (TF). RESULTS. Four of the 17 patients with AKS had CR, 10 a PR, and three were TF and died rapidly from their disease. The combined chemotherapeutic regimens produced marked symptomatic relief and even long-term remission in AKS. In patients with EKS, the response rate to chemotherapy was very low and of brief duration. No patient had a CR and debilitating side effects were common. CONCLUSIONS. The African type of AKS is a chemo-sensitive tumor, whereas the endemic type EKS, like its Western counterpart, has a dismal prognosis.

25
UI - 8567117
AU - Ziegler JL; Katongole-Mbidde E
TI - Kaposi's sarcoma in childhood: an analysis of 100 cases from Uganda and relationship to HIV infection.
SO - Int J Cancer 1996 Jan 17;65(2):200-3
AD - Uganda Cancer Institute, Kampala, Uganda.
We report 100 cases of Kaposi's sarcoma (KS) in children under 15 years of age treated at the Uganda Cancer Institute in the 6-year period 1989-1994. The incidence of childhood KS has risen more than 40-fold in the era of AIDS, and 78% of 63 cases tested were seropositive for HIV-1. There were 63 boys and 37 girls. The median age was 4 years and the median age of onset was 33 months. Tumour distribution was lymphadenopathic and muco-cutaneous, with 2 major patterns: pattern I, oro-facial dominant (79%); and pattern II, inguinal-genital dominant (13%). A newly described herpes-like virus is implicated as the cause of KS (KSHV), and DNA sequences of this virus were present in all of 8 childhood cases tested. If KSHV is a direct cause of KS, this tumour distribution in children suggests mucosal routes of virus entry, possibly during birth or breast feeding. The dramatic increase of childhood KS implies that the prevalence of causative factors is rising in Uganda.

26
UI - 8640089
AU - Su IJ; Huang LM; Wu SJ; Jin YT; Kao YF; Tsai TF; Lee JY; Hsu YH; Hsiao
TI - CH; Chang YC; Wang YW; Lee CY Detection and sequence analysis of a new herpesvirus-like agent in AIDS and non-AIDS Kaposi's sarcoma in Taiwan.
SO - J Formos Med Assoc 1996 Jan;95(1):13-8
AD - Department of Pathology, National Cheng Kung University Medical College and Hospital, Tainan, Taiwan, ROC.
A new herpesvirus-like DNA sequence (KSHV) has been recently identified in Kaposi's sarcoma from acquired immunodeficiency syndrome (AIDS) and non-AIDS patients. In order to verify the role of this new viral agent in Taiwan, a series of Kaposi's sarcoma specimens obtained from AIDS and non-AIDS patients in three medical centers representing different geographic locations of Taiwan were surveyed. A total of seven specimens from AIDS patients and 22 specimens from non-AIDS patients were tested for the presence of this herpesvirus-like agent by polymerase chain reaction (PCR) using the published Kaposi's sarcoma 330-233 primers. The tumor DNA was also tested for cytomegalovirus (CMV), Epstein-Barr virus (EBV), and human herpes-virus type 6 (HHV-6). The Kaposi's sarcoma specimens from AIDS and non-AIDS patients were positive for KSHV except in one case. Only occasional specimens were positive for CMV and EBV, with a slightly higher positive rate for HHV-6 in AIDS and non-AIDS patients. Cloning and sequence analysis of the PCR products from two cases of Kaposi's sarcoma (one each for AIDS and non-AIDS) revealed only minor differences in this DNA sequence, as compared with the published data from north America. These results further support the assumption that this new KSHV is strongly associated with Kaposi's sarcoma in AIDS and non-AIDS patients in Taiwan.

27
UI - 8783952
AU - Bakari M; Pallangyo K; Kitinya J; Mbena E; Urassa W
TI - The importance of clinical features in differentiating HIV related from non-HIV related Kaposi's sarcoma: experience from Dar es Salaam, Tanzania.
SO - Trop Doct 1996 Jul;26(3):104-7
AD - Department of Internal Medicine, Muhimbili Medical Centre, Dar es Salaam, Tanzania.

28
UI - 9365767
AU - Ziegler JL; Newton R; Katongole-Mbidde E; Mbulataiye S; De Cock K;
TI - Wabinga H; Mugerwa J; Katabira E; Jaffe H; Parkin DM; Reeves G; Weiss R; Beral V Risk factors for Kaposi's sarcoma in HIV-positive subjects in Uganda.
SO - AIDS 1997 Nov;11(13):1619-26
AD - International Agency for Research on Cancer, World Health Organization, Lyon, France.
BACKGROUND: Kaposi's sarcoma (KS) is associated epidemiologically with HIV infection and with human herpesvirus 8 (HHV-8 or KSHV). Both KS and HIV infection are common in Uganda. We conducted a case-control study of 458 HIV-seropositive. Ugandan adults with KS and 568 HIV-seropositive subjects without KS to examine risk factors for HIV-associated KS. METHODS: We recruited newly diagnosed adult KS cases from five hospitals in Kampala, Uganda and controls from a large referral clinic for HIV infection at Mulago Hospital. All cases and controls were counselled and tested for HIV and answered an interviewer-administered questionnaire about their home, socio-economic conditions, lifestyle and sexual behaviour before they became ill. Only HIV-seropositive subjects were included in the analysis. RESULTS: There were 295 males and 163 females with KS and 227 male and 341 female controls. Age distribution was similar but there was a higher proportion of cases (45%) than controls (29%) residing in rural regions of Uganda. KS cases were more likely than controls to have a higher level of education (X2 for trend, 4.8; P = 0.03), to have occupations associated with affluence [chi 2 for heterogeneity, 17.3 on 5 degrees of freedom (df); P = 0.004] and to come from larger settlements [adjusted odds ratio (OR) for settlements of > 1000 versus 10-99 houses, 1.8; 95% confidence interval (CI), 1.1-3.0]. Cases were more likely than controls to have high household income (chi 2 for trend, 32.6; P < 0.001) and other markers of urban or rural wealth such as owning several cows (chi 2 for trend, 9.5; P = 0.002). Cases were more likely to travel away from home (adjusted OR, 1.6; 95% CI, 1.1-2.3) and more likely to have spent increasing time in contact with water (chi 2 for trend, 12.3; P < 0.001). Few indices of sexual behaviour were related to risk of KS, including reported number of sexual partners. Cases were more likely than controls to be married to one rather than several spouses (adjusted OR, 1.6; 95% CI, 1.2-2.2) and to have reported a history of sexually transmitted diseases (STD) (adjusted OR, 1.6; 95% CI, 1.2-2.3). CONCLUSIONS: Among HIV-infected subjects, KS cases are characterized by better education and greater affluence, compared with controls. Urban address, travel away from home, exposure to water, monogamous marriage and self-reported STD were also more frequent among KS cases than controls. The higher socio-economic status of persons with HIV and KS may be a marker for enhanced exposure to a possibly sexually transmitted agent, or for a delayed exposure to a childhood infection. The risk posed by exposure to water among KS cases requires further study.

29
UI - 12049697
AU - Podzamczer D; Miralles P; La Calle Md M; Zarco C; Berenguer J; Lopez
TI - Aldeguer J; Valencia E; Rubio R; Ribera JM [Recommendations of GESIDA/Spanish National Plan of AIDS on diagnosis and treatment of Kaposi's sarcoma and cervical cancer in HIV-infected patients]
SO - Med Clin (Barc) 2002 Jun 1;118(20):788-95
AD - Ciutat Sanitaria de Bellvitge, L'Hospitalet, Barcelona, Spain. pmiralles@eresmas.net

30
UI - 12297590
AU - Polk S; Munoz A; Sacktor NC; Jenkins FJ; Cohen B; Miller EN; Jacobson LP
TI - A case-control study of HIV-1-related dementia and co-infection with HHV-8.
SO - Neurology 2002 Sep 24;59(6):950-3
AD - Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA.
This nested case-control study assessed the putative protective effect of human herpesvirus-8 (HHV-8) against HIV-1-related dementia (dementia). The HHV-8 seropositivity of 210 male age- and HIV disease stage-matched cases and controls was compared. The overall HHV-8 seropositivity of 66% was similar among demented HIV-infected cases and nondemented HIV-infected controls.

31
UI - 12204098
AU - van der Kuyl AC; van den Burg R; Zorgdrager F; Dekker JT; Maas J; van
TI - Noesel CJ; Goudsmit J; Cornelissen M Primary effect of chemotherapy on the transcription profile of AIDS-related Kaposi's sarcoma.
SO - BMC Cancer 2002 Sep 2;2(1):21
AD - Department of Human Retrovirology, Academic Medical Center, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands. a.c.vanderkuyl@amc.uva.nl
BACKGROUND: Drugs & used in anticancer chemotherapy have severe effects upon the cellular transcription and replication machinery. From in vitro studies it has become clear that these drugs can affect specific genes, as well as have an effect upon the total transcriptome. METHODS: Total mRNA from two skin lesions from a single AIDS-KS patient was analyzed with the SAGE (Serial Analysis of Gene Expression) technique to assess changes in the transcriptome induced by chemotherapy. SAGE libraries were constructed from material obtained 24 (KS-24) and 48 (KS-48) hrs after combination therapy with bleomycin, doxorubicin and vincristine. KS-24 and KS-48 were compared to SAGE libraries of untreated AIDS-KS, and to libraries generated from normal skin and from isolated CD4+ T-cells, using the programs USAGE and HTM. SAGE libraries were also compared with the SAGEmap database. RESULTS: In order to assess the primary response of AIDS-related Kaposi's sarcoma (AIDS-KS) to chemotherapy in vivo, we analyzed the transcriptome of AIDS-KS skin lesions from a HIV-1 seropositive patient at two time points after therapy. The mRNA profile was found to have changed dramatically within 24 hours after drug treatment. There was an almost complete absence of transcripts highly expressed in AIDS-KS, probably due to a transcription block. Analysis of KS-24 suggested that mRNA pool used in its construction originated from poly(A) binding protein (PABP) mRNP complexes, which are probably located in nuclear structures known as interchromatin granule clusters (IGCs). IGCs are known to fuse after transcription inhibition, probably affecting poly(A)+RNA distribution.Forty-eight hours after chemotherapy, mRNA isolated from the lesion was largely derived from infiltrating lymphocytes, confirming the transcriptional block in the AIDS-KS tissue. CONCLUSIONS: These in vivo findings indicate that the effect of anti-cancer drugs is likely to be more global than up- or downregulation of specific genes, at least in this single patient with AIDS-KS. The SAGE results obtained 24 hrs after chemotherapy can be most plausibly explained by the isolation of a fraction of more stable poly(A)+RNA.

32
UI - 7724724
AU - Villone G
TI - [AIDS in Naples in 1800. 12 cases of Kaposi sarcoma described by Tommaso de Amicis]
SO - Hist Philos Life Sci 1994;16(2):275-309
AD - Dipartimento di Medicina Sperimentale, Clinica Universita degli Studi di Reggio Calabria, Catanzaro, Italy.
In 1882, Tommaso de Amicis, dermatologist and venereologist at the University of Naples, Italy, published a description of twelve cases of Kaposi's sarcoma. This article is the second report about the above-mentioned disease after the first description of five cases by Moritz Kaposi ten years earlier. The publication by De Amicis was organized as a collection of case reports followed by a section containing general considerations about the etiopathogenesis, pathology, diagnosis and therapy of Kaposi's sarcoma. Ten cases are typical of the so-called 'classic' form of the disease, that has a peculiar indolent chronic course, while two out of the twelve cases strongly resemble the clinical form of Kaposi's sarcoma currently recognized as that associated with the acquired immunodeficiency syndrome (AIDS). The nature of Kaposi's sarcoma is still being debated, but current evidence suggests that it is a viral-associated, if not viral-induced, tumor and its relationship with AIDS is that of an opportunistic disease. Thus, the presence of the clinical form of AIDS-related Kaposi's sarcoma can be used as a marker of the presence of sporadic cases of AIDS much earlier than its pandemic diffusion.

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