AIDS-Related Kaposi’s Sarcoma (AKS) and Treatment Outcome at Muhimbili National Hospital and Ocean Road Cancer Institute in Tanzania
DOI:
https://doi.org/10.55677/IJCSMR/V2I6-01/2022Keywords:
Kaposi’s sarcoma, HIV/AIDS, Presentation, Treatment, HAART, TanzaniaAbstract
Background: Kaposi’s sarcoma (KS) is a systemic multifocal angiomatous tumor presenting with purplish macular/papular, plaques or nodular lesions and four clinicopathological types namely classical/sporadic (CKS), African endemic (EKS), iatrogenic (IKS) and AIDS-associated (AKS). It is the commonest HIV/AIDS-related cancer in Africa. The introduction of highly-active-antiretroviral-therapy (HAART) has drastically reduced the incidence of KS and altered its clinical course but in Tanzania few current reports have been documented on treatment outcome including its use. The aim of this study was to determine the frequency, clinical presentation, treatment and associated factors at Muhimbili National Hospital (MNH) and the Ocean Road Cancer Institute (ORCI).
Methods: A hospital-based cross-sectional study using archival records of patients admitted at MNH from January-December 2015 and treatment information/outcome from ORCI.
Results: Out of 120 patients 71.7% were HIV positive (AKS), the rest were endemic (EKS) and males were older and more frequently affected than females. Majority (61.5%, n=64/104) with KS morbidity and mortality (62.5%, n=10/16) were from younger age-groups probably due to AKS. AKS patients more frequently (23.33%, n=28/120) presented with generalized disease compared to EKS (5.83%, n=7/120) [p = 0.0263]. Histopathologically, advanced (plaque+nodular) lesions were more (58.3%, n=72/120) frequent in AKS. Most (95%) of AKS patients received HAART and majority (95.95%, n=71/74) were alive during data collection (p<0.0001). Apparently, more (88.2%) patients with EKS were alive compared to AKS (86.0%). Conversely, majority (81.3%, n=12/16) of those dead had AKS.
Conclusion: KS is still common in Tanzania, mostly in association with HIV/AIDS. AKS contributed to younger age, generalized disease and advanced histopathological stages at presentation. Chemo-radiotherapy and radiotherapy-alone modalities appeared more beneficial and showed less mortality. The use of HAART seems to reduce the negative impact of AKS.
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