The picture of HIV and its associated infections looks very different in Africa than in the developed world, but historically, studies to characterize diseases or disease characteristics unique to resource-poor countries have lagged behind their description in richer countries. Pediatric Kaposi sarcoma is such a disease. KS is a cancer caused by infection with human herpesvirus 8 (HHV-8). Although KS is prevalent in HIV infected adults worldwide, and is one of the most common childhood cancers in sub-Saharan Africa, it is virtually never seen in children in the U.S.
To get a better view of how African children with KS present and how they respond to treatment, VIDI affiliate investigator Dr. Soren Gantt and colleagues looked at 73 HIV positive children with KS at the Uganda Cancer Institute. As compared to adults with KS, these children were more likely to have cancerous lymph nodes and less likely to have characteristic skin lesions. Because HHV-8 infection in Uganda is acquired during childhood and can cause enlarged lymph nodes, the increased involvement of lymph nodes in pediatric KS might reflect a more rapid progression of cancer after acute HHV-8 infection in HIV positive children. Although children who received chemotherapy and antiretroviral therapy appeared to have largely favorable responses, over half the children were lost to follow up. The differences the researchers found between pediatric and adult KS point to a need to better understand this disease’s unique effects on children, and the optimal way to treat it.
Clinical presentation and outcome of epidemic Kaposi sarcoma in Ugandan children. Gantt S, Kakuru A, Wald A, Walusansa V, Corey L, Casper C, Orem J. Pediatr Blood Cancer. 2010 May;54(5):670-4.