ABSTRACT
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.
Subject(s)
AIDS-Related Opportunistic Infections , Sarcoma, Kaposi , AIDS-Related Opportunistic Infections/drug therapy , AIDS-Related Opportunistic Infections/epidemiology , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Retrospective Studies , Sarcoma, Kaposi/drug therapy , Sarcoma, Kaposi/epidemiology , Togo/epidemiology , Young AdultABSTRACT
OBJECTIVE: Determine the prevalence of latent TB infection in HIV-infected people. METHOD: Using a cross-sectional study on HIV-infected persons monitored in the Department of Lung and Infectious Diseases of CHU Sylvanus Olympio of Lomé from August 10, 2010 to November 10, 2010. All patients are receiving anti-retroviral therapy and have no clinical or radiological symptoms of TB, and had never received tuberculin skin test (TST) in the last 3months. The CD4 rate of all patients was more than 200cells/µl. The diagnosis of latent TB infection is based on the measurement of at least 5mm of skin induration, 72h after a subcutaneous injection of 5IU of purified tuberculin. RESULTS: One hundred and fifty four persons were included in the study, of which 107 were female and 47 were male. The median age was 40years old. Eleven patients were exposed to a risk of TB and only 70.7% of patients had a BCG scar. A suspicion of former TB was found in 18.8% of patients and approximately 45% of patients were very immunocompromised with a CD4 rate between 200 and 350; 117 patients had a positive TST. This represents an overall prevalence of 76% of latent TB infection. CONCLUSION: The prevalence of latent TB infection obtained with the TST is high in this study. A similar study using the interferon-gamma release assay, which is more specific, would be more helpful to obtain more reliable epidemiological data on patient outcomes and to determine the appropriateness of the use of chemoprophylaxis with isoniazid.
