INFLUENCE OF HIV EPIDEMIC ON THE INCIDENCE OF KAPOSIS-SARCOMA IN ZAMBIAN CHILDREN

Acquired immunodeficiency syndrome-associated Kaposi's sarcoma (KS) is well documented in adults. However, very little information is availa ble about KS in the pediatric age group. A retrospective study was und ertaken at the University Teaching Hospital (UTH), Lusaka, Zambia, to define the incidence and clinical profile of KS in Zambian children ov er the last 13 years and to determine the influence, if any, of the cu rrent human immunodeficiency virus (HIV) epidemic on the pattern of pe diatric KS. All the histopathological records from 1980 to 1992 were r eviewed and all cases of KS along with the total number of malignancie s, both in children and adults, were analyzed. Along with this, 17 of 23 case files of pediatric KS patients treated at the UTH since 1984 w ere retrieved and clinical details recorded. Of a total of 915 cases o f KS, 85 (9.25%) were in children <14 years of age. The age ranged fro m 7 months to 14 years, with an average of 5.62 years; the male/female ratio was 1.76:1. A significant increase in the incidence of pediatri c KS has been recorded since 1987 (p < 0.001). This coincides with the advent of the HIV epidemic in the country. The disease was aggressive and fulminant in pediatric patients. More than 80% HIV seropositivity was detected. Children with blood transfusion-related HIV infection h ad cutaneous or lymphocutaneous disease, indicating that the mode of a cquisition of HIV infection may influence the clinical appearance of K S, Thus, HIV-associated KS in children is becoming a common entity in Zambia. An urgent prospective epidemiologic study is needed to address this problem in HIV-affected regions.