Kaposi Sarcoma (KS)
Please click on the link below to access the most up-to-date version of this guideline. The content on this page is currently being updated to align with the latest publication. Always check the version number at the bottom of the screen to confirm which version you are using. Click here to access the Adult Hospital Level Chapter 10: HIV_and_AIDS_with_supporting_NEMLC_Report_Reviews_2025-9-Versio
Please click on the link below to access the most up-to-date version of this guideline. The content on this page is currently being updated to align with the latest publication. Always check the version number at the bottom of the screen to confirm which version you are using.
Description
Medicine treatment
Referral
B21.0
DESCRIPTION
Kaposi Sarcoma (KS) is a malignancy of lymphatic endothelial origin associated with Human Herpes Virus-8, also known as KS Herpes Virus, infection.
KS may involve the skin, oral cavity, lymph nodes or viscera (especially lung and GIT).
Most patients have multiple lesions.
Lymphoedema is a common complication.
10 - 20% of cases of visceral KS will have no oral or skin involvement.
KS is an AIDS-defining illness (WHO clinical stage 4).
Although most cases are diagnosed on the typical macroscopic appearance of skin and oral lesions, biopsy confirmation is necessary for atypical lesions and consideration for chemotherapy. One important differential diagnosis is bacillary angiomatosis, which develops more rapidly.
MEDICINE TREATMENT
All patients with KS should be commenced on ART (see Antiretroviral therapy) and cotrimoxazole prophylaxis (see Opportunistic infection prophylaxis, with cotrimoxazole) regardless of CD4 count.
Many patients with limited mucocutaneous KS will have complete resolution or substantial regression on ART alone.
REFERRAL
Prior to referral, all patients must be started on ART.
- Radiotherapy/intralesional chemotherapy for symptomatic local lesions.
- Systemic chemotherapy is indicated in patients with poor prognostic factors:
- more than 25 skin lesions,
- rapidly progressive disease,
- visceral involvement,
- extensive oedema, or
- "B" symptoms, i.e. fever, night sweats, significant constitutional symptoms.
- Failure of KS to respond to ART.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Adult Hospital Level, 2020-2024_Version 2.1_09 December 2024
Chapter 10 HIV and AIDS_10.4 Kaposi Sarcoma (KS)