title: A case of Kaposi sarcoma in an immunocompetent, heterosexual Irish man: a discussion of etiology and viral transmission.
abstract: Four types of Kaposi sarcoma (KS) have been described, all of which are caused by human herpesvirus-8 (HHV-8).  The incidence of KS in the United States is highest among HIV-positive homosexual men and elderly men of Eastern European, Jewish, or Mediterranean descent. However, few reports describe KS in HIV-negative, immunocompetent heterosexual men in the United States. HHV-8 is transmitted largely via saliva and close sexual contact, whereas there are only a handful of reports of transmission via blood and blood products. We report a case of an HIV-negative, immunocompetent heterosexual man who acquired KS via blood transfusion. A 77-year-old immunocompetent, monogamously heterosexual, HIV-negative Irish man presented with a biopsy-proven KS lesion on the right thigh. Past surgical history included a coronary artery bypass graft, during which he received a blood transfusion from an unknown donor source.  His ecchymotic KS lesions progressed while on doxycycline, intralesional vinblastine, and topical anti-angiogenic medications.  The patient eventually achieved stabilization of KS lesions with acitretin. Our case report emphasizes the need to characterize the phenotype and transmission route of HHV-8 in heterosexual, immunocompetent patients in geographic regions with low HHV-8 seroprevalence.
authors.affiliation: University of Colorado Denver, Anschutz Medical Campus.
authors.forename: Aleksandra G
authors.initials: AG
authors.lastname: Florek
authors.forename: David
authors.initials: D
authors.lastname: Eilers
authors.forename: April W
authors.initials: AW
authors.lastname: Armstrong
mesh_terms: D000368:Aged; D001706:Biopsy; D015658:HIV Infections / Q000208:ethnology / Q000473:pathology / Q000821:virology; D015497:HIV-1; D020010:Heterosexuality / Q000208:ethnology*; D006801:Humans; D016867:Immunocompromised Host; D007494:Ireland / Q000208:ethnology; D008297:Male; D012514:Sarcoma, Kaposi / Q000208:ethnology / Q000473:pathology / Q000821:virology; D014481:United States / Q000453:epidemiology