Kaposi Sarcoma With Long Term Disease Control On Pazopanib in a Young HIV-Positive Male from Northeast India: a case report.

Abstract

Kaposi sarcoma (KS) is a rare vascular tumor and an acquired immunodeficiency syndrome-defining illness 
commonly associated with human herpesvirus-8 (HHV-8) infection. It is typically seen in individuals with advanced immunosuppression and low CD4+ T-cell counts. We report the case of a 15-year-old male of Naga ethnicity from 
Nagaland, India, who was diagnosed with human immunodeficiency virus (HIV) infection at birth and was initiated on antiretroviral therapy. In July 2018, he presented with a painless nodular swelling on the left side of the neck and bilateral pedal edema. Clinical examination revealed violaceous skin nodules. A biopsy from the nodular lesion confirmed the diagnosis of KS, with positive immunohistochemical staining for CD31, CD34, and HHV-8. Subsequently, he was initiated on pazopanib, an oral tyrosine kinase inhibitor, in December 2019. The patient achieved a partial response with disease stabilization, which was sustained until the last follow-up in May 2025. This case underscores the importance of considering KS in adolescents with HIV infection, even in low-prevalence regions. It highlights the diagnostic value of immunohistochemistry in confirming the disease and demonstrates the potential utility of pazopanib as a viable treatment option in refractory cases.