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AIDS-related Kaposi sarcoma: Clinical manifestations and diagnosis

Jerome E Groopman, MD
Section Editor
David M Aboulafia, MD
Deputy Editor
Sadhna R Vora, MD


Kaposi sarcoma (KS) is a vascular tumor that is etiologically associated with human herpesvirus 8 (HHV-8), which is also known as the KS-associated herpesvirus (KSHV) [1]. (See "Disease associations of human herpesvirus 8 infection".)

The clinical manifestations and diagnosis of AIDS-related KS will be reviewed here. The treatment of AIDS-related KS is discussed separately, as is the classic form of Kaposi sarcoma. (See "AIDS-related Kaposi sarcoma: Staging and treatment" and "Classic Kaposi sarcoma: Clinical features, staging, diagnosis, and treatment" and "Classic Kaposi sarcoma: Epidemiology, risk factors, pathology, and molecular pathogenesis".)


Epidemiologic forms — There are four epidemiologic forms of KS, all of which have been related to infection with HHV-8. These include:

AIDS-related or epidemic KS — AIDS-related or epidemic KS is the most common tumor arising in HIV-infected persons. KS is considered an AIDS-defining illness in the Centers for Disease Control and Prevention (CDC) guidelines. In the United States, KS was over 20,000 times more common in persons with AIDS than in the general population prior to the widespread use of potent antiretroviral therapy (ART), although its incidence has declined substantially since that time [2].

Endemic or African — KS was endemic in all parts of equatorial Africa, particularly in sub-Saharan Africa, prior to the HIV epidemic. Since the onset of the HIV epidemic, the incidence of KS has increased dramatically in those regions [3,4].

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Literature review current through: Nov 2017. | This topic last updated: Oct 20, 2016.
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  1. Moore PS, Chang Y. Detection of herpesvirus-like DNA sequences in Kaposi's sarcoma in patients with and those without HIV infection. N Engl J Med 1995; 332:1181.
  2. Beral V, Peterman TA, Berkelman RL, Jaffe HW. Kaposi's sarcoma among persons with AIDS: a sexually transmitted infection? Lancet 1990; 335:123.
  3. Stefan DC, Stones DK, Wainwright L, Newton R. Kaposi sarcoma in South African children. Pediatr Blood Cancer 2011; 56:392.
  4. Senba M, Buziba N, Mori N, et al. Increased prevalence of Kaposi΄s sarcoma-associated herpesvirus in the Kaposi΄s sarcoma-endemic area of western Kenya in 1981-2000. Acta Virol 2011; 55:161.
  5. Iscovich J, Boffetta P, Winkelmann R, et al. Classic Kaposi's sarcoma in Jews living in Israel, 1961-1989: a population-based incidence study. AIDS 1998; 12:2067.
  6. Fenig E, Brenner B, Rakowsky E, et al. Classic Kaposi sarcoma: experience at Rabin Medical Center in Israel. Am J Clin Oncol 1998; 21:498.
  7. Lodi S, Guiguet M, Costagliola D, et al. Kaposi sarcoma incidence and survival among HIV-infected homosexual men after HIV seroconversion. J Natl Cancer Inst 2010; 102:784.
  8. Yanik EL, Achenbach CJ, Gopal S, et al. Changes in Clinical Context for Kaposi's Sarcoma and Non-Hodgkin Lymphoma Among People With HIV Infection in the United States. J Clin Oncol 2016; 34:3276.
  9. Ledergerber B, Telenti A, Egger M. Risk of HIV related Kaposi's sarcoma and non-Hodgkin's lymphoma with potent antiretroviral therapy: prospective cohort study. Swiss HIV Cohort Study. BMJ 1999; 319:23.
  10. International Collaboration on HIV and Cancer. Highly active antiretroviral therapy and incidence of cancer in human immunodeficiency virus-infected adults. J Natl Cancer Inst 2000; 92:1823.
  11. Mocroft A, Kirk O, Clumeck N, et al. The changing pattern of Kaposi sarcoma in patients with HIV, 1994-2003: the EuroSIDA Study. Cancer 2004; 100:2644.
  12. Engels EA, Pfeiffer RM, Goedert JJ, et al. Trends in cancer risk among people with AIDS in the United States 1980-2002. AIDS 2006; 20:1645.
  13. Eltom MA, Jemal A, Mbulaiteye SM, et al. Trends in Kaposi's sarcoma and non-Hodgkin's lymphoma incidence in the United States from 1973 through 1998. J Natl Cancer Inst 2002; 94:1204.
  14. Yanik EL, Napravnik S, Cole SR, et al. Incidence and timing of cancer in HIV-infected individuals following initiation of combination antiretroviral therapy. Clin Infect Dis 2013; 57:756.
  15. Osmond DH, Buchbinder S, Cheng A, et al. Prevalence of Kaposi sarcoma-associated herpesvirus infection in homosexual men at beginning of and during the HIV epidemic. JAMA 2002; 287:221.
  16. Martin JN, Ganem DE, Osmond DH, et al. Sexual transmission and the natural history of human herpesvirus 8 infection. N Engl J Med 1998; 338:948.
  17. Rezza G, Andreoni M, Dorrucci M, et al. Human herpesvirus 8 seropositivity and risk of Kaposi's sarcoma and other acquired immunodeficiency syndrome-related diseases. J Natl Cancer Inst 1999; 91:1468.
  18. Sitas F, Carrara H, Beral V, et al. Antibodies against human herpesvirus 8 in black South African patients with cancer. N Engl J Med 1999; 340:1863.
  19. Trattner A, Hodak E, David M, Sandbank M. The appearance of Kaposi sarcoma during corticosteroid therapy. Cancer 1993; 72:1779.
  20. Gill PS, Loureiro C, Bernstein-Singer M, et al. Clinical effect of glucocorticoids on Kaposi sarcoma related to the acquired immunodeficiency syndrome (AIDS). Ann Intern Med 1989; 110:937.
  21. Litwin MA, Williams CM. Cutaneous Pneumocystis carinii infection mimicking Kaposi sarcoma. Ann Intern Med 1992; 117:48.
  22. Mitsuyasu RT. Clinical variants and staging of Kaposi's sarcoma. Semin Oncol 1987; 14:13.
  23. Ioachim HL, Adsay V, Giancotti FR, et al. Kaposi's sarcoma of internal organs. A multiparameter study of 86 cases. Cancer 1995; 75:1376.
  24. Caponetti G, Dezube BJ, Restrepo CS, Pantanowitz L. Kaposi sarcoma of the musculoskeletal system: a review of 66 patients. Cancer 2007; 109:1040.
  25. Bower M, Dalla Pria A, Coyle C, et al. Prospective stage-stratified approach to AIDS-related Kaposi's sarcoma. J Clin Oncol 2014; 32:409.
  26. Nichols CM, Flaitz CM, Hicks MJ. Treating Kaposi's lesions in the HIV-infected patient. J Am Dent Assoc 1993; 124:78.
  27. Danzig JB, Brandt LJ, Reinus JF, Klein RS. Gastrointestinal malignancy in patients with AIDS. Am J Gastroenterol 1991; 86:715.
  28. Laine L, Amerian J, Rarick M, et al. The response of symptomatic gastrointestinal Kaposi's sarcoma to chemotherapy: a prospective evaluation using an endoscopic method of disease quantification. Am J Gastroenterol 1990; 85:959.
  29. Friedman SL, Wright TL, Altman DF. Gastrointestinal Kaposi's sarcoma in patients with acquired immunodeficiency syndrome. Endoscopic and autopsy findings. Gastroenterology 1985; 89:102.
  30. Polizzotto MN, Uldrick TS, Wyvill KM, et al. Clinical Features and Outcomes of Patients With Symptomatic Kaposi Sarcoma Herpesvirus (KSHV)-associated Inflammation: Prospective Characterization of KSHV Inflammatory Cytokine Syndrome (KICS). Clin Infect Dis 2016; 62:730.