Changing patterns of Kaposi's sarcoma in N.E. Zaire

Abstract

A minor change in the pattern of Kaposi's sarcoma has been noticed in north-east Zaire. This is characterized by a small increase of the number of confirmed diagnoses, together with the appearance of the disease amongst women, who tend to be of a younger age group. These data suggests the appearance of a new aetiological factor in the area. From recent reports from other parts of Africa we speculate that this might be the appearance of HTLV-III virus.

PIP: Kaposi's sarcoma has been a familiar phenomenon to physicians in Central Africa for many years. In its classic presentation, Kaposi's sarcoma is a very slowly progressive disease of the extremities characterized by purple or hyperpigmented nodules, local chronic edema, and a typical histologic picture. There appears to be no connection between this endemic form of the disease and acquired immunodeficiency syndrome (AIDS). However, workers in the northeastern corner of Zaire are now encountering cases of atypical Kaposi, especially among females, that may be associated with seropositivity to the AIDS virus. In this area, the number of cases of Kaposi's sarcoma has increased from an average of 7/year before 1983 to 14 cases/year in 1983-85. From 1971-80, only 1 woman was diagnosed with Kaposi's sarcoma; however, 13 cases were confirmed among women in 1981-85 (5 in 1985 alone). The 10 women diagnosed in 1983-85 averaged 32 years of age and the 34 men diagnosed in this period averaged 40 years of age, indicating a trend toward younger age at onset of disease. The recent Kaposi's sarcoma cases have been of the nodular variety, with occasional visceral involvement. The changes in the pattern of Kaposi in northeast Zaire suggest the appearance of a new etiological factor in the area, quite possibly human immunodeficiency virus imported from other parts of Africa.