Before the AIDS epidemic, Kaposi sarcoma (KS) rarely occurred in the United States. Most often, the types of KS that occurred were classic and iatrogenic. At that time, only about 2 new cases of KS were found for every million people in the United States each year. This changed with the AIDS epidemic.
It has been estimated that an HIV-infected person has a 20,000 times increased risk of developing KS compared with people without HIV. AIDS patients with KS increased the rate of KS in this country more than 20 times — peaking at 47 cases per million people (per year) in the early 1990s. Early in the AIDS epidemic, patients infected with HIV in the United States were estimated to have a 1 in 2 chance of developing KS.
With new treatments for AIDS, KS has become less common in the United States, and it now occurs at a rate of about 7 cases per million people each year. It is still seen most often in people infected with HIV. In the United States, KS is much more common in men than in women, and it is rarely seen in children. It is also more common in African Americans than in whites in the United States. In areas of the world (such as Africa) where Kaposi sarcoma herpesvirus (KSHV) and HIV infection rates are high, both endemic and HIV-associated KS are seen, and KS occurs in men, women, and children.
Transplant recipients are another group that gets KS. About 1 in 200 transplant patients in the United States gets KS. This occurs primarily because they were already infected with KSHV before the transplant; they just didn't have any symptoms. The drugs they take to suppress their immune system allow KS to develop.
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