KAPOSIS-SARCOMA IN CHILDHOOD - AN ANALYSIS OF 100 CASES FROM UGANDA AND RELATIONSHIP TO HIV-INFECTION

We report 100 cases of Kaposi's sarcoma (KS) in children under 15 year s of age treated at the Uganda Cancer Institute in the 6-year period 1 989-1994. The incidence of childhood KS has risen more than 40-fold in the era of AIDS, and 78% of 63 cases tested were seropositive for HIV -1. There were 63 boys and 37 girls. The median age was 4 years and th e median age of onset was 33 months. Tumour distribution was lymphaden opathic and muco-cutaneous, with 2 major patterns: pattern I, ore-faci al dominant (79%); and pattern II, inguinal-genital dominant (13%). A newly described herpes-like virus is implicated as the cause of KS (KS HV), and DNA sequences of this virus were present in all of 8 childhoo d cases tested. If KSHV is a direct cause of KS, this tumour distribut ion in children suggests mucosal routes of virus entry, possibly durin g birth or breast feeding. The dramatic increase of childhood KS impli es that the prevalence of causative factors is rising in Uganda. (C) 1 996 Wiley-Liss, Inc.