John Libbey Eurotext

Médecine et Santé Tropicales

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Maladie de Kaposi associée au VIH : 103 observations en dermatologie à Lomé (Togo) Volume 23, numéro 1, Janvier-Février-Mars 2013

Auteurs
Service de dermatologie, CHU Sylvanus Olympio, BP 30785 Lomé, Togo, Service de dermatologie, CHU Kara, Togo, Service des maladies infectieuses, CHU Sylvanus Olympio, BP 30785 Lomé, Togo, Service de dermatologie, CHU Campus, Lomé, Togo, Service de médecine interne, CHU Sylvanus Olympio, BP 30785 Lomé, Togo
  • Mots-clés : Kaposi's sarcoma, HIV, Togo
  • DOI : 10.1684/mst.2013.0145
  • Page(s) : 109-11
  • Année de parution : 2013

Objective: The purpose of this study was to describe the epidemiological and clinical profile and the treatment and natural history of AIDS-related Kaposi sarcoma in 3 major dermatology departments in Lomé (Togo). Patients and method: This retrospective, descriptive study was based on the records of patients with AIDS-related Kaposi sarcoma from January 2005 through October 2011. Results: During the study period, 157 patients were treated in the dermatology departments for Kaposi sarcoma. HIV serology was positive for 103 (89.6%) of the 115 patients tested. Seventy-nine patients were known to be HIV-positive before the consultation, while Kaposi sarcoma was the circumstance of discovery of the HIV infection for 24. The average age of the 103 patients was 36.7±14.9 years and the sex-ratio (M/F) was 1.1. The main locations of the lesions were the lower limbs (n = 76), mucosa (n = 53), trunk (n = 38) and upper limbs (n = 17). The average CD4-cell count was 226±168 cells/mm 3. The main antiretroviral protocol used was stavudine/lamivudine/nevirapine (70 cases). Besides the antiretroviral treatment, chemotherapy was prescribed, with vinblastine for 17 patients, bleomycin for 5, and doxorubicin for one. For financial reasons, 80 other patients did not receive chemotherapy and were lost to follow-up after an average duration of 3 months. At 5 months, the rate of complete remission was 21.1%, partial remission 21.1%, and failure 57.8%. Side effects were dominated by hematologic and nervous complications. Conclusion: Our study highlighted a high prevalence of AIDS-related Kaposi sarcoma in dermatology departments in Lomé, with a tendency to gender equality. It also shows the difficulties of access to chemotherapy for most patients and the poor efficacy of chemotherapy.