Trends in Kaposi’s disease in the hospital setting from 1990 to 2020 in Lomé (Togo)

Objective: The aim of this study was to describe the evolution of Kaposi’s disease (KD) between 1990 and 2020 in dermatology in Lomé (Togo). Patients and Method: This is a series of cases of KD including all the records of patients seen on an outpatient basis or hospitalised for KD of clinical and/or histological diagnosis between 1990 and 2000 (period of non-general introduction of ART), 2000 to 2010 (initial and increasing introduction of ART) and between 2010 and 2020 (period of general introduction of ART) in the public dermatology departments of Lomé. Results: During the study period, 307 cases of MK were recorded, with a hospital frequency of 0.24%. The mean age of the patients was 40.03±13.71 years, with extremes ranging from 6 to 90 years and a male predominance (M/F= 1.5). The overall frequencies of KD from 1990 to 2000, 2000 to 2010 and 2010 to 2020 were 0.10, 0.30 and 0.25 respectively (p=0.002) and were dominated by HIV-associated KD (66%). During the same periods, 1990 to 2000, 2000 to 2010 and 2010 to 2020, the overall incidence was 3.00, 12.20 and 14.09 respectively (p<0.0001). Of the 307 patients, 13.7% (n=42) died, the majority in the HIV-associated form of KD. Conclusion: Our study shows a significant increase in the incidence of MK over the 30 years of the study, with a predominance of HIV-associated MK. The generalized use of antiretroviral treatment with the «test and treat» strategy will help to reduce this mortality.