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Kaposi Sarcoma HD Non-HIV — ESENeph MCQ

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HardHaemodialysisKaposi Sarcoma HD Non-HIVESENeph

A 65-year-old man with CKD G5 on haemodialysis develops a skin lesion on his forearm. Biopsy shows Kaposi sarcoma (HHV-8 positive). He has no HIV. What is the main risk factor in this context?

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Correct answer: D — Chronic immunosuppression and CKD – Kaposi sarcoma can occur in dialysis patients even without HIV, associated with HHV-8 and uraemia-related immunosuppression

Kaposi sarcoma can occur in dialysis patients without HIV, driven by HHV-8 infection in the context of uraemia-related immune dysfunction. This is sometimes called 'iatrogenic' or 'classic' Kaposi sarcoma in immunosuppressed non-HIV patients. Dialysis patients have impaired T-cell immunity, facilitating HHV-8 reactivation. Management depends on extent: localised lesions may be treated with radiation or excision; widespread disease may require chemotherapy. Post-transplant, it is more common due to additional pharmacological immunosuppression.

Reference: KDIGO 2009 – Transplant (Cancer chapter); Tessari et al 2006 – KS in Dialysis