{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T04:07:32Z","timestamp":1789877252469,"version":"4.0.1"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,11,21]],"date-time":"2018-11-21T00:00:00Z","timestamp":1542758400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Clinical and Translational Science Institute Grant","award":["UL1TR000124UCLA"],"award-info":[{"award-number":["UL1TR000124UCLA"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Despite widespread antiretroviral coverage in Botswana, Kaposi's sarcoma (<jats:styled-content style=\"fixed-case\">KS<\/jats:styled-content>) remains among the most common malignancies. To date, adult <jats:styled-content style=\"fixed-case\">KS<\/jats:styled-content> in Botswana is not well characterized. The diagnosis relies on clinical suspicion that is often confirmed by histopathology given the implications of treatment; however, this poses a significant resource burden.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective review of the cohort of patients biopsied for possible <jats:styled-content style=\"fixed-case\">KS<\/jats:styled-content> at Princess Marina Hospital, the main dermatology referral site in Botswana, from September 2008 through June 2015 to describe the demographics, human immunodeficiency virus (HIV) characteristics, and clinical presentations of these patients. Histopathologic diagnoses were reviewed, and positive predictive value (<jats:styled-content style=\"fixed-case\">PPV<\/jats:styled-content>) was used to characterize the accuracy of clinical suspicion of <jats:styled-content style=\"fixed-case\">KS<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 441 patients received 450 biopsies where <jats:styled-content style=\"fixed-case\">KS<\/jats:styled-content> was on the differential diagnosis, and 239 patients (54%) were ultimately diagnosed with <jats:styled-content style=\"fixed-case\">KS<\/jats:styled-content>. The <jats:styled-content style=\"fixed-case\">KS<\/jats:styled-content> cohort was more likely to be male (58% vs. 37%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> positive (94% vs. 85%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05), and have lower <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4 counts at the time of biopsy (274\u00a0cells\/\u03bcl vs. 362\u00a0cells\/\u03bcl, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05). The <jats:styled-content style=\"fixed-case\">PPV<\/jats:styled-content> of clinical suspicion of <jats:styled-content style=\"fixed-case\">KS<\/jats:styled-content> was 58%. When <jats:styled-content style=\"fixed-case\">KS<\/jats:styled-content> was not histopathologically diagnosed, clinically benign diseases were found in 17%, medically significant conditions requiring alternative therapies in 78%, and life\u2010threatening diseases in 5%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Our study reinforces the risk factors in development of <jats:styled-content style=\"fixed-case\">KS<\/jats:styled-content>. The poor <jats:styled-content style=\"fixed-case\">PPV<\/jats:styled-content> supports the important role of histology in <jats:styled-content style=\"fixed-case\">KS<\/jats:styled-content> diagnosis to both ensure appropriate treatment and prevent overtreatment. Improved accessibility to biopsy and augmentation of local dermatopathologic services would likely improve diagnostic accuracy and treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijd.14305","type":"journal-article","created":{"date-parts":[[2018,11,21]],"date-time":"2018-11-21T12:58:41Z","timestamp":1542805121000},"page":"707-712","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["A retrospective review of patients with Kaposi's sarcoma in Botswana"],"prefix":"10.1111","volume":"58","author":[{"given":"Christa","family":"Slaught","sequence":"first","affiliation":[{"name":"Department of Dermatology Oregon Health and Sciences University Portland OR USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Williams","sequence":"additional","affiliation":[{"name":"Ministry of Health of Botswana Gaborone Botswana"},{"name":"Department of Dermatology Perelman School of Medicine at the University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surbhi","family":"Grover","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Pennsylvania Philadelphia PA USA"},{"name":"Department of Oncology Princess Marina Hospital Gaborone Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Bigger","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Massachusetts General Hospital Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukendi","family":"Kayembe","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology National Health Laboratory Gaborone Botswana"},{"name":"Department of Pathology University of Botswana School of Medicine Gaborone Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebathu","family":"Chiyapo","sequence":"additional","affiliation":[{"name":"Department of Oncology Princess Marina Hospital Gaborone Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas J.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Medicine Statistics Core David Geffen School of Medicine University of California, Los Angeles Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Dryden\u2010Peterson","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Brigham and Women's Hospital Boston MA USA"},{"name":"Botswana Harvard AIDS Institute Gaborone Botswana"},{"name":"Harvard T. 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Chan School of Public Health Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie L.","family":"Kovarik","sequence":"additional","affiliation":[{"name":"Department of Dermatology Perelman School of Medicine at the University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karolyn A.","family":"Wanat","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Pathology University of Iowa Iowa City IA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,11,21]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.51.6757"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2012-0101-RS"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-med-050409-103711"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCO.0b013e328355e14b"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.29210"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0b013e328333b892"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/1758-2652-13-23"},{"key":"e_1_2_5_9_1","first-page":"CD003256","article-title":"Treatment of severe or progressive Kaposi's sarcoma in HIV\u2010infected adults","author":"Gbabe OF","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.18.1.19929"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1258\/ijsa.2009.009145"},{"key":"e_1_2_5_12_1","unstructured":"Network NCC.National Comprehensive Cancer Network Harmonized Guidelines for Sub\u2010Saharan Africa: Kaposi Sarcoma.2017."},{"key":"e_1_2_5_13_1","unstructured":"ElmoreSN KayembeMKA ZolaM et\u00a0al.Demographic characteristics and preliminary outcomes in a cohort of HIV\u2010positive patients with Kaposi's sarcoma in a high ART coverage setting: a report from Botswana. 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