{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T05:11:43Z","timestamp":1775279503985,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T00:00:00Z","timestamp":1673308800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The Kaposi sarcoma (KS) T0 versus T1 staging classification does not address the unique clinical features of paediatric KS in human gammaherpesvirus 8 (HHV\u20108) endemic regions of Africa. This study seeks to define patterns of childhood KS using a paediatric\u2010specific approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Lilongwe paediatric KS staging classification categorizes disease based on clinical phenotype: stage 1\u00a0=\u00a0mild\/moderate KS limited to cutaneous\/oral involvement, stage 2\u00a0=\u00a0primarily lymphadenopathic disease, stage 3\u00a0=\u00a0woody edema KS, stage 4\u00a0=\u00a0visceral and\/or severe\/disseminated mucocutaneous disease. Characteristics and outcomes were evaluated from paediatric referral centres in Lilongwe, Malawi, and Mbeya, Tanzania.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 171 patients, the median age was 9.3\u2009years, 37% (<jats:italic>n<\/jats:italic>\u00a0=\u00a063) were female, and 87% (<jats:italic>n<\/jats:italic>\u00a0=\u00a0149) had HIV. Breakdown by stage was as follows: 18% (<jats:italic>n<\/jats:italic>\u00a0=\u00a031) stage 1, 33% (<jats:italic>n<\/jats:italic>\u00a0=\u00a056) stage 2, 19% (<jats:italic>n<\/jats:italic>\u00a0=\u00a033) stage 3, and 30% (<jats:italic>n<\/jats:italic>\u00a0=\u00a051) stage 4. Age (younger stage 2 and older stage 3), severe CD4 count suppression (lower CD4 for stages 1 and 4), and presence of severe anaemia and thrombocytopenia (worse for stages 2 and 4) differed across stages. Estimated 2\u2010year event\u2010free survival\/progression\u2010free survival\/overall survival by stage was as follows: stage 1, 81%\/81%\/87%; stage 2, 50%\/50%\/63%; stage 3, 24%\/49%\/81%; and stage 4, 29%\/34%\/54%. Sub\u2010analysis of stage 2 lymphadenopathic KS demonstrated superior long\u2010term 6\u2010year event\u2010free survival of 70% (95% confidence interval [CI] 49\u201383) for younger children (aged &lt;7\u2009years) versus 27% (95% CI 8\u201351) for older children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This paediatric\u2010specific staging classification categorizes patients with distinct characteristics and patterns of treatment response. This platform may guide clinicians to provide risk\u2010stratified treatment with the hope of improving survival among children with KS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.13455","type":"journal-article","created":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T00:54:25Z","timestamp":1673398465000},"page":"664-675","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Divergent clinical presentations and outcomes among children and adolescents with Kaposi sarcoma in Malawi and Tanzania"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3868-9312","authenticated-orcid":false,"given":"Liane R.","family":"Campbell","sequence":"first","affiliation":[{"name":"Baylor College of Medicine International Pediatric AIDS Initiative at Texas Children's Hospital  Houston Texas USA"},{"name":"Department of Pediatrics Baylor College of Medicine  Houston Texas USA"},{"name":"Baylor College 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