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  • Kaposi sarcoma

    Kaposi Sarcoma is caused by a viral infection called herpesvirus 8 (KSHV) that affects the skin and limbs as well as the mouth, gastrointestinal tract and respiratory tract.

    Kaposi Sarcoma is a rare tumor that develops from KSHV when the immune system is weakened. More than likely, it develops when HIV damages the immune system, which affects those who are infected with the virus.

    Similar to AIDS, kaposi sarcoma is not curable and can grow again several years after being treated. It is one of the most common AIDS symptoms and its diagnoses is confirmed when a detection of LANA, a KSHV protein, is found in the tumor cells.

    Predominantly found in men, kaposi sarcoma develops from cells that line the lymph and blood vessels and becomes life threatening when the tumor is found in the digestive tract, lungs, or liver.

    Kaposi sarcoma is vascular (being composed of vessels or ducts that contain fluids as blood, lymph, or sap) and contains dense, disfigured blood vessels that leak red blood cells causing the skin’s appearance to take on a reddish-purple hue. The lesions are palpable (raised) and posses features that are plaque-like. Although treatable, kaposi sarcoma and its virus are avoidable as long as the proper measures are taken to protect your body.

    History

    Discovered by Moritz Kaposi, a dermatologist who studied at the University of Vienna in 1872, Kaposi Sarcoma was not declared a viral case until 1994. Being a huge epidemic in the 1980’s, KSHV was prevalent among homosexual men. At one point, Kaposi Sarcoma was researched in hopes to reveal the causes of AIDS, but the results remain unknown.

    Classification

    • Classic KS: In most cases, Classic KS is benign and targets elderly men from the Mediterranean region who are of an Eastern Europe decent. The lesions are commonly found on the legs, ankles, and the soles of feet. A few of its characteristics include limited and slow growth. If diagnosed with Classic KS, the immune system is more likely to withstand the tumor than those of other classifications.
    • Epidemic KS: Compared to other classifications of KS, Epidemic KS is the only one that is actually AIDS related, but is the most common. It is aggressive, hard to treat, and develops in individuals who have HIV.
    • Endemic (African) KS: Similar to Epidemic KS, Endemic KS is also aggressive with its target being the skin instead of the mouth or the essential systems of the body. Being more likely to develop in young African Americans (from sub-Saharan Africa), it is most common in Africa due to unknown factors and affects mainly children and women less than 40 years old. Often times, it can appear before puberty. This type of Kaposi Sarcoma attacks the lymph nodes and other organs that can lead to death.
    • Iatrogenic (Transplant Oriented) KS: This type of Kaposi Sarcoma occurs when an organ transplant is given that overtime weakens the immune system. The cause of the suppressed immune system is due to the drugs one takes to prevent the patient’s body from rejecting the new organ. If drugs were not taken, the Kaposi Sarcoma lesion would either disappear or shrink. This particular type of KS spread dramatically in the 1980s.

    General Prognosis / Statistics

    Kaposi Sarcoma’s prognosis is very good, for the tumors can be controlled. In more dangerous cases where the tumor is aggressive, the patient’s prognosis depends on the patient’s medical condition. Other factors that determine the prognosis of the patient include whether or not the diagnosis is for the first time, or if it’s a reccurrence, and the type of KS being diagnosed.

    Statistics:

    • KS is more likely to be found in oral samples than in genital samples.
    • Can be transmitted orally (kissing).
    • 20% of homosexual men who have HIV have Kaposi Sarcoma.
    • 3% of KS cases occur in transfusion recipients.
    • 1% occurs in hemophiliacs.
    • Only 6% of men are aware.
    • KS is the site of 15% of AIDS cases.

    In 40% or more, patients with AIDS associated Kaposi Sarcoma found the lesions will shrink after using HAART (treatment).

    Risk Factors

    Being infected with KSHV: Having the virus definitely increases an individuals chance for developing Kaposi Sarcoma especially if the immune system has been weakened.

    • Ethnicity: Being of the African or Mediterranean decent can greatly affect you
    • Gender: Generally men are more prone to developing KS.
    • Sexual Activity: Homosexual men are at very high risk for KS even though many scientists and doctors are not sure why. KSHV is more often spread through saliva than with drug users whose needles often become contaminated with blood that carries the virus.

    Previously had lymphoma (a tumor arising from any of the cellular elements of lymph nodes) or tuberculosis (an infectious disease that may affect almost any tissue of the body, especially the lungs).

    Symptoms

    Kaposi Sarcoma could actually be one of the first signs of AIDS. One symptom that makes it very obvious a KS lesion is present is the presence of a bluish-red color on the skin which may be a sign of the tumor. Similar to HIV, KSHV is hard to detect with a few vague symptoms such as:

    • Fever
    • Sweating
    • Weight loss
    • Immune system suppression

    If such symptoms occur, or if evidence leads you to believe you may have Kaposi Sarcoma, consult your doctor who will perform a physical exam and may use a bronchoscope to examine the lungs or an endoscope to examine the stomach and intestinal tract if there is a suspicion of Kaposi Sarcoma within internal organs.

    A biopsy and chest x-ray are other ways of examining cells, tissues, organs and bones to find the presence of Kaposi Sarcoma.

    Treatment

    Similar to any tumor, the goal of treatment is to remove as much of the tumor as possible. Radiation therapy is an option if the KS lesions haven’t spread too far or hardly at all. Radiation helps control the disease in the area that it is being treated. Having a Kaposi Sarcoma tumor surgically removed is also an option if the KS lesions are small enough and haven’t spread to far to other organs of the body.

    Both radiation and chemotherapy are options for KS that is widespread among the human body. Very few patients are treated with chemotherapy since Kaposi Sarcoma is such a rare disease and radiation therapy can treat the infected area well. There is no other way to prevent Kaposi Sarcoma than to consult a doctor with your sexaul partner to confirm the absent presence of the virus.