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Acquired immunodeficiency syndrome-related Kaposi's sarcoma
C Y Wang1, A L Schroeter, W P Su
1Department of Dermatology, Mayo Clinic Rochester, MN 55905, USA.
Objective:
To describe Kaposi's sarcoma (KS) associated with the acquired immunodeficiency syndrome (AIDS).
Design:
A review of AIDS-related KS (AIDS-KS), with its associated epidemiologic and etiologic characteristics, pathogenesis, clinical manifestations, histopathologic features, prognosis, and treatment, is presented.
Results:
KS is the most frequent malignant lesion in patients with AIDS. The incidence of AIDS-KS is high in homosexual and bisexual men who have multiple sexual partners and in children and women with the human immunodeficiency virus (HIV) infection. Anal-oral contact is one of the main routes of the sexually transmitted agents of AIDS-KS. The major pathogenic factors that may possibly induce AIDS-KS are HIV itself or other sexually transmitted agents, HIV tat gene, some oncogenes and cytokines such as interleukin 6, basic fibroblast growth factor, transforming growth factor-beta, oncostatin M, and platelet-derived growth factor. Treatment includes local therapy, radiotherapy, systemic chemotherapy, zidovudine, interferon, granulocyte-macrophage colony-stimulating factor, and other agents.
Conclusion:
KS may be an early manifestation of AIDS and the most frequent neoplastic complication of AIDS. Growth factors, cytokines, immunosuppression, and interaction with infectious agents seem to have a role in the development of this enigmatic disorder. Treatment of KS should be individualized. Further investigation of the agents and factors of AIDS-KS may help facilitate the treatment and prevention of this neoplasm.