AIDS-related Kaposi's sarcoma: Epidemiological, diagnostic, treatment and control aspects in sub-Saharan Africa
Date
2005
Authors
Sissolak G.
Mayaud P.
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Abstract
Until the 1980s, little attention had been accorded to endemic Kaposi's sarcoma (KS), a neoplasm noted in several parts of Southern Europe and the African continent but with relatively slow progression, except in children and young adults. Furthermore, therapeutic approaches based on surgery, radiation and topical treatment were of limited efficacy, mostly used to overcome the disabling and stigmatizing effects of the disease. With the emergence of the HIV/AIDS epidemic, and the profound impact of KS on AIDS-related mortality, the pathogenesis of KS has been better studied, and the realisation that a virus (KS-associated Herpesvirus or Human Herpesvirus 8, or KSHV/HHV-8), combined with immunosuppression and cytokine-induced growth, was responsible for the development of this disease has led to novel therapeutic approaches. These are unfortunately still highly toxic, require careful monitoring, and are expensive, thus limiting their use in most parts of Africa. However, the use of highly active antiretroviral therapy (HAART), which has led to a considerable decline in KS incidence in populations of industrialized countries, constitutes the best hope for the control of this stigmatizing and lethal disease in Africa. Trials comparing different regimens of antiretroviral drugs in combination with systemic chemotherapeutic agents are urgently needed. © 2005 Blackwell Publishing Ltd.
Description
Keywords
aciclovir; alitretinoin; alpha interferon; anthracycline; antineoplastic agent; antiretrovirus agent; bleomycin; cidofovir; dactinomycin; doxorubicin; etoposide; foscarnet; fumagillol chloroacetylcarbamate; ganciclovir; im 862; peginterferon alpha2b; retinoid; RNA directed DNA polymerase inhibitor; thalidomide; vinblastine; vincristine; medical geography; acquired immune deficiency syndrome; Africa; article; cancer staging; cancer surgery; chill; clinical trial; cryotherapy; depression; disease association; disease transmission; drowsiness; drug half life; drug monitoring; drug potentiation; drug response; fatigue; fever; headache; highly active antiretroviral therapy; human; Human herpesvirus 8; immunotherapy; Kaposi sarcoma; low level laser therapy; malaise; myositis; nausea; neutropenia; pathogenesis; radiation; rash; serodiagnosis; seroprevalence; side effect; virus detection; Acquired Immunodeficiency Syndrome; Adult; Africa South of the Sahara; Antineoplastic Agents; Antiretroviral Therapy, Highly Active; Developing Countries; Herpesviridae Infections; Herpesvirus 8, Human; HIV Infections; Humans; Interferon-alpha; Xeroderma Pigmentosum; Herpesviridae; Human herpesvirus 8
Citation
Tropical Medicine and International Health
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