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<p>Kaposi sarcoma (KS) is a vascular tumor caused by human herpesvirus 8 (HHV-8) and is traditionally classified into classic, endemic, epidemic, and iatrogenic subtypes. However, recent reports describe a fifth KS type occurring in human immunodeficiency virus (HIV)-negative, immunocompetent men who have sex with men (MSM), which has emerged as a distinct entity with evolving characterization. We conducted a retrospective review of KS cases diagnosed at our institution between 2000 and 2024 to evaluate the clinical and epidemiologic features of KS in HIV-negative, immunocompetent adult men whose presentations do not align with existing subtype classifications. Patients were excluded if they were over 50 years old, from endemic regions, HIV-positive, or immunosuppressed. Twelve patients met the inclusion criteria, with a median age of 42 years. Seven (58.3%) identified as MSM and five (41.7%) as non-MSM. Histories of sexually transmitted infections were frequent among MSM patients, though not significantly different from the non-MSM subgroup. Pre-exposure prophylaxis (PrEP) use after KS diagnosis was significantly more likely among MSM than non-MSM patients. Lesions most commonly affected the lower extremities, and initial management varied from observation to excision, with mixed clinical responses at follow-up. Notably, we identified five HIV-negative, immunocompetent, non-MSM patients with KS who lacked clear alignment with known subtypes, a finding that suggests current KS classifications may not fully capture the clinical spectrum of disease among these patients. Further investigation is warranted to clarify the pathogenesis of KS, identify transmission dynamics, and explore potentially unidentified risk factors in this population.</p>

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Reassessing Kaposi sarcoma subtypes: a case series of HIV-negative, immunocompetent young men

  • 期刊论文

  • 发表日期：

    2026年1月13日

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  • Elissa J. Goorman,
  • Sukul Mittal,
  • Amar D. Desai,
  • Lida Zheng,
  • Cuong V. Nguyen

摘要

Kaposi sarcoma (KS) is a vascular tumor caused by human herpesvirus 8 (HHV-8) and is traditionally classified into classic, endemic, epidemic, and iatrogenic subtypes. However, recent reports describe a fifth KS type occurring in human immunodeficiency virus (HIV)-negative, immunocompetent men who have sex with men (MSM), which has emerged as a distinct entity with evolving characterization. We conducted a retrospective review of KS cases diagnosed at our institution between 2000 and 2024 to evaluate the clinical and epidemiologic features of KS in HIV-negative, immunocompetent adult men whose presentations do not align with existing subtype classifications. Patients were excluded if they were over 50 years old, from endemic regions, HIV-positive, or immunosuppressed. Twelve patients met the inclusion criteria, with a median age of 42 years. Seven (58.3%) identified as MSM and five (41.7%) as non-MSM. Histories of sexually transmitted infections were frequent among MSM patients, though not significantly different from the non-MSM subgroup. Pre-exposure prophylaxis (PrEP) use after KS diagnosis was significantly more likely among MSM than non-MSM patients. Lesions most commonly affected the lower extremities, and initial management varied from observation to excision, with mixed clinical responses at follow-up. Notably, we identified five HIV-negative, immunocompetent, non-MSM patients with KS who lacked clear alignment with known subtypes, a finding that suggests current KS classifications may not fully capture the clinical spectrum of disease among these patients. Further investigation is warranted to clarify the pathogenesis of KS, identify transmission dynamics, and explore potentially unidentified risk factors in this population.