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The Tanzania cancer registry recorded 39,920 cancer cases from 1968 to 1995. Kaposi's sarcoma (KS) constituted 4% of the cases of which 79.9% were males. During the AIDS period changes in the demographics of KS were noted showing an increase in the diagnosis of KS (p=0.0001). There was an overall decrease in the mean age from 41.7 years before to 37.3 years during the AIDS epidemic (p=0.002). In males this decreased from 42.7 to 38.8 years (p=0.01) but was not statistically significant in females (p=0.06). In both periods the cases were observed in the sexually active age groups. The narrowing of the male/female ratio during the AIDS period (p=0.0004), and an increase in extra-limb lesions from 19.7% before to 48.7% during the AIDS epidemic indicates the emergence of an aggressive form of KS in Tanzania, suggesting a co-factor role of HIV in KS pathogenesis.

Kaposi's sarcoma (KS) was up to the 1980's seen as a rare indolent sporadic disease in Southern Europe and as an endemic disease in East and Central Africa. With the onset of the HIV/AIDS epidemic a more aggressive, disseminated type of KS was recognized in HIV infected people with AIDS. Interestingly, KS has not been reported in Indians living in Africa for several generations. Recently KS was however, diagnosed in two Tanzanian Indians, both infected with HIV. Clinical and pathological studies of these two cases showed the characteristic hallmarks of KS in both HIV infected and uninfected people. From the literature and cancer registry data it appears that KS has been even more rare in India and other Far Eastern countries, compared to Europe and the Americas, with only a few cases reported with and without HIV association. The present data and that reported earlier in the literature support the notion of an infectious agent transmitted sexually in the pathogenesis of KS. Ethnic/genetic factors could also be of importance.