Kaposi Sarcoma

Kaposi sarcoma is a cancer arising from the cells lining blood and lymphatic vessels, caused by human herpesvirus 8 (HHV-8). It occurs much more frequently in people with advanced HIV infection and is one of the AIDS-defining illnesses.

• Purple, brown, or reddish-blue patches, plaques, or nodules on the skin, most often on the legs, face, or mouth
• Lesions may also occur on internal organs, including the lungs and gastrointestinal tract, which can cause breathlessness or gastrointestinal bleeding
• Swelling of the legs due to lymphatic involvement
• Skin lesions are usually painless but can ulcerate or bleed

• Caused by human herpesvirus 8 (HHV-8) infection.
• Occurs far more commonly and aggressively in people with advanced, untreated HIV infection due to severe immune suppression.
• Can also occur, though less commonly and more slowly, in people without HIV, particularly older men in some regions or transplant recipients on immunosuppressive medicine.

• Often suspected clinically from the characteristic appearance of skin lesions, especially in a person with known or newly diagnosed HIV infection.
• Skin biopsy confirms the diagnosis on histological examination.
• Assessment for internal organ involvement (such as chest X-ray for lung involvement) is carried out if suggested by symptoms.

Starting or optimising antiretroviral therapy (ART) is the essential first step, as immune recovery alone can lead to significant improvement or resolution of limited skin disease.

Localised skin lesions may be managed with ART alone or with local treatment where available.

More extensive skin disease or involvement of internal organs requires systemic chemotherapy, given at a specialised oncology centre alongside continued ART.

Regular follow-up is needed to monitor response to treatment and HIV control.

• Early diagnosis and prompt initiation of antiretroviral therapy for anyone diagnosed with HIV, since good HIV control greatly reduces the risk of Kaposi sarcoma.
• Routine HIV testing to identify infection before advanced immune suppression develops.
• Regular clinical follow-up for people living with HIV to detect new skin lesions early.