Non-Aids Associated Kaposi Sarcoma amongst 4 Patients in Cameroon (Central Africa)

Background: Kaposi sarcoma is very strongly associated with HIV infection. The disease is rare in HIV negative patients and has distinct clinical and prognostic attributes from AIDS associated counterpart. The group at risk to develop non-AIDS related KS in our community are elderly men, although both sexes and children are not immune to the disease. Patients and Methods: In order to define risk-groups and major clinical features we retrospectively evaluated clinical data of all patients with non-AIDS associated KS in the Yaounde population in Cameroon, Central Africa, between 2004 and 2014, a period of 10 years. Data were extracted from the Yaounde Cancer Registry and from patient records for the period under study. Results: 4 patients were identified with non-AIDS Kaposi sarcoma in a ten years study period giving an incidence of 2.5 in this community. The average age at onset of the disease was 42 years. The patients ranged in age from 6-64 years and included 3 (75%) males and 1 (25%) female with a male-to-femaleratio of 3:1. The tumour was located in the skin (50%), cervical lymph nodes (25%) and viscera (25%). 3 patients had a localized disease at time of diagnosis against 1 with a metastatic disease. This later died of his disease 2 years after diagnosis, while 2 others were doing well after treatment and 1 was lost to follow up. 2(50%) of the KS clinical subtypes were classified to be of the African endemic type, while1 (25%) was classic and the other (25%) was unclassified. Conclusion: Kaposi sarcoma does occur in HIV negative patients. Unlike KS in AIDS patients, non-AIDS associated Kaposi sarcoma is a localized disease which mostly involves the skin of the lower limb, common in elderly otherwise healthy men but also in women and children and responds well to treatment. Kaposi sarcoma should be actively ruled out in clinical, biological and pathologic investigations of all patients including HIV sero negative patients.