Association Between Histopathological Stage and Clinicopathological Characteristics of Head and Neck Kaposi Sarcoma: HHV8-Mediated Oncogenesis Within an ART Era in a Resource-Limited Setting of Ga-Rankuwa

Head and neck Kaposi sarcoma (HNKS) is a vascular neoplasm, associated with human herpesvirus 8 (HHV-8) infection and immunosuppression; it is one of the most common malignancies among people living with human immunodeficiency virus (PLWHIV). Comprehensive characterisation of HNKS aetiopathogenesis and clinicopathological critical for timeous diagnosis and prognosis is essential. A retrospective, descriptive cross-sectional study was conducted on forty-one histopathologically confirmed HNKS cases diagnosed between 2004 and 2024. Formalin-fixed, paraffin-embedded (FFPE) sections were retrieved and stained for immunohistochemical (IHC) biomarkers. Associations between variables were evaluated using Fisher’s exact test. The study cases showed a male: female ratio of 1.05:1 and a mean age of 33.4 ± 11.6 years. HIV positivity was documented in 85.4% of patients. Nodular stage predominated (63.4%); classical KS was the most common histopathological variant (82.9%). The CD34 endothelial biomarker was positive in all 41 cases (100%). HHV-8, D2-40, and p53 were positive in 51.2%, 45%, and 47.5% of cases respectively; high Ki-67 (≥15%) was observed in 25% of cases. No statistically significant associations were identified between stage and clinicopathological features (all p > 0.05). The epidemic KS was most common, predominantly affecting young adults. The combination of CD34, D2-40 and HHV8 may improve diagnostic accuracy. The prognostic/diagnostic roles of p53 and Ki-67 remain unelucidated.