AEGiS-15IAC: HIV Kaposis sarcoma in a Mother Child Pair.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

HIV Kaposis sarcoma in a Mother Child Pair.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. B10053)

Mosam A, Thejpal R, Goga Y, Page T, Cassol E, Coovadia HM, Cassol S
Nelson R Mandela School of Medicine, Durban, South Africa

BACKGROUND: The simultaneous occurrence of KS in mother-child pairs has been documented in only 2 other case reports from Zimbabwe and Zambia. We report the occurrence of KS in mother and child pair from South Africa co-infected with HIV 1 Clade C and Human Herpesvirus 8 (HHV 8) subtype B viral infection.

METHODS: A 4 year old African male child was admitted with generalized lymphadenopathy and subcutaneous nodules. In addition there were violaceous patches on the trunk, hepatromegaly, PR bleeding and bilateral lower limb lymphoedema. He had a pancytopaenia, was HIV-1 +ve with a CD4 count was 361 cells /mm³, CD8 1338 cells/mm³ and viral load of 270 000 copies/ml (5.43 log). A biopsy of the nodules and lymph nodes confirmed a diagnosis of Kaposi's sarcoma. The childs mother, a 22 year old African woman was well looking and on examination had lesions of KS on her face, arms and trunk which were confirmed histologically to be KS. Her chest radiograph was normal and her blood investigations were as follows: blood, renal and liver function were normal, HIV positive, CD4 + 133 cells/mm³, CD8 1338 cells/mm³and HIV viral load 290 000 copies/ml (5.46 log).

RESULTS: He was commenced on chemotherapy with and tolerated this well. The lymph nodes and cutaneous lesions regressed. He remains well. The mother was commenced on ART and after 3 months her CD4 was and VL remains<LDL. Her cutaneous lesions remain ISQ. The mother and child are HIV-1 subtype C for the pol region and HHV-8 subtype A5 for the K1 region.

CONCLUSION: This is the first reported case HIV KS in a mother child pair in South Africa and the first which has described the HIV -1 and HHV 8 subtypes. The presentation will also detail modalities of spread of HHV 8 especially with respect to this case.

Keywords: AEGIS, Sarcoma, Kaposi, Acquired Immunodeficiency Syndrome, HIV Seropositivity, Herpesvirus 8, Human, HIV-1, Viral Load, CD4 Lymphocyte Count, Mothers, Skin Neoplasms, Zambia, Zimbabwe, South Africa, Child, Humans, Female, Male

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B10053