Kaposi Sarcoma is a type of cancer that frequently appears in individuals with weakened immune systems, particularly those with advanced human immunodeficiency virus (HIV) infection (AIDS). It is characterized by the growth of abnormal tissue. While Kaposi Sarcoma can affect various parts of the body, it is most commonly observed on the skin.
The Link Between Kaposi Sarcoma and AIDS
Kaposi Sarcoma is directly linked to infection with human herpesvirus 8 (HHV-8), also referred to as Kaposi Sarcoma-associated Herpesvirus (KSHV). This virus causes Kaposi Sarcoma. While HHV-8 infection is necessary for Kaposi Sarcoma to develop, a compromised immune system, often due to AIDS, allows the virus to activate and cause lesions.
HIV, the virus that causes AIDS, severely weakens the body’s immune defenses by attacking and destroying T-cells, a type of white blood cell that fights infection. When the immune system is suppressed, HHV-8 can proliferate unchecked, leading to Kaposi Sarcoma. This explains why Kaposi Sarcoma became much more prevalent with the AIDS epidemic, especially in regions where HHV-8 is common.
Recognizing Kaposi Sarcoma
The primary signs of Kaposi Sarcoma are visible lesions that can appear on the skin, mucous membranes, lymph nodes, and internal organs. These lesions often begin as flat patches and can progress to raised nodules or plaques. Their color typically ranges from red to purple, brown, or dark, sometimes resembling bruises.
Common locations for skin lesions include the feet, legs, and face, though they can develop anywhere. Lesions on mucous membranes, such as in the mouth, nose, throat, or genital areas, may also occur. Internal lesions cause varied symptoms depending on the affected organ; for instance, lung lesions might cause shortness of breath or coughing up blood, while those in the digestive tract can result in abdominal pain, nausea, vomiting, or bloody stools. Swollen lymph nodes, fatigue, and weakness are also potential indicators, particularly in advanced cases.
Diagnosis and Treatment Approaches
Diagnosing Kaposi Sarcoma typically involves a physical examination to observe any suspicious lesions, followed by a biopsy. During a biopsy, a small tissue sample is removed from a lesion and examined under a microscope by a pathologist to confirm the presence of Kaposi Sarcoma cells. Imaging tests like chest X-rays, CT scans, bronchoscopies, or endoscopies may be performed to check for lesions in internal organs, especially if symptoms suggest internal involvement.
Treatment for Kaposi Sarcoma is individualized and often focuses on managing the underlying HIV infection. Antiretroviral therapy (ART) is a cornerstone of treatment for HIV-associated Kaposi Sarcoma. ART works by strengthening the immune system, which can cause Kaposi Sarcoma lesions to shrink or prevent them from worsening. For localized skin lesions, treatments like radiation therapy, cryotherapy, or surgical removal may be used. Systemic chemotherapy, often with drugs like liposomal doxorubicin, is considered for widespread lesions, rapidly progressing disease, or involvement of internal organs.
Managing HIV/AIDS to Prevent Kaposi Sarcoma
Consistent and early antiretroviral therapy (ART) for HIV infection plays a significant role in preventing the development and progression of Kaposi Sarcoma. By effectively suppressing the HIV virus, ART helps to restore and maintain a strong immune system. A robust immune system is better equipped to control HHV-8, thereby reducing the risk of HHV-8 reactivation and the subsequent formation of Kaposi Sarcoma lesions.
Individuals with HIV who maintain higher CD4 cell counts, which indicate a healthier immune system, are less likely to develop Kaposi Sarcoma or experience severe forms of the disease. The widespread use of ART has led to a notable reduction in the incidence of HIV-associated Kaposi Sarcoma and improved outcomes for affected individuals. Even if Kaposi Sarcoma develops, effective HIV management with ART can lead to lesion regression and a better prognosis.