A fifth subtype of Kaposi's sarcoma, classic Kaposi's sarcoma in men who have sex with men: a cohort study in Paris

Abstract

Background

Classic Kaposi's sarcoma (CKS) occurs predominantly among elderly men and is associated with KSHV (Kaposi's Sarcoma-Associated Herpesvirus). In low endemic countries, KSHV infects predominantly men having sex with men (MSM).

Objectives

To describe a cohort of classic Kaposi sarcoma in a low endemic area for KSHV, to highlight the features of CKS in MSM and identify prognostic factors.

Methods

Retrospective single-center study of CKS cases. We compared MSM to heterosexual patients. Then, we divided the patients into two subgroups, those requiring a systemic treatment and the others, and we performed univariate and multivariate analysis to determine aggressiveness of CKS.

Results

Between 2006 and 2015, seventy-four patients were included. Mean age at diagnosis was 68.9 years, sex ratio (M/F) was 6.4 and 28% were MSM; MSM patients were younger (p=0.02), less often originated from endemic areas (p<0.0001). KS was less severe (p=0.04), required more often a local treatment than a systemic one (p=0.03). On multivariate analysis, CD4 T cell count> 500/mm³ at baseline was associated with a reduced risk of severe evolution.

Conclusion

First CKS cohort in low endemic zone. We describe a fifth subtype of KS: KS in MSM. The CD4 T-cell count was found to correlate with prognosis.

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