The frequency and distribution of gastrointestinal Kaposi's sarcoma were investigated in 63 consecutive AIDS patients. The main risk factor for AIDS was heterosexual intercourse. Gastrointestinal lesions were found in 24 cases (38.1%): 12 patients (11.1%) had both upper and lower GI tract involvement, 7 patients (11.1%) had only oesophago-gastroduodenal lesions and 5 (7.9%) only lower tract disease. Our results show that in heterosexual Africans, the tumours closely resemble the tumours of western homosexuals in endoscopic appearance, in being multicentric and in the gastro-intestinal tract involved. We conclude that even in the heterosexual African AIDS population, the gastrointestinal tract is frequently involved and this phenomenon, if more widely studied might give us new elements about the aetiophatogenesis of Kaposi's sarcoma which is still unclear.
PIP: Acquired immunodeficiency syndrome (AIDS) was first reported in Uganda in 1982. As techniques for detecting AIDS have improved, the number of confirmed cases has increased. Kaposi's sarcoma (KS) has been reported in European studies of AIDS patients at a 34% prevalence rate. These studies mainly focused on homosexuals and intravenous drug users (IVDUs). This study aimed at establishing the frequency, distribution, and endoscopic appearance of gastrointestinal KS in Ugandan heterosexual patients and at verifying whether data published in the western international literature, mainly regarding homosexuals and IVDUs, could be applied to heterosexuals with AIDS. 27 Ugandan men and 36 Ugandan women served as study subjects. All had been diagnosed as AIDS-positive. All patients received complete upper and lower gastrointestinal examinations. The upper digestive tract was examined by oral-endoscopic procedures, while the lower portion was examined using flexible rectosigmoidoscopic techniques. 24 patients (38.1%) had gastrointestinal lesions; 21 of these (87.5%) had multiple lesions. 12 patients (19.1%) had KS involvement of both gastrointestinal areas. Tumors closely resembled those described in studies of homosexuals.