Introduction. In 2010 more than 3 million children with human immunodeficiency virus (HIV) were living in Sub-Saharan Africa. The AIDS epidemic has contributed to an abrupt increase of the frequency of Kaposi sarcoma (KS), especially in Southern Africa. There is a need to describe the clinical features of this disease, its management, and its outcome in HIV positive children in Southern Africa. The aim of the study is to describe two different populations with HIV and KS from two African hospitals in Namibia and South Africa. Material and Methods. A retrospective descriptive study of patients with KS who presented to Tygerberg Hospital (TH) and Windhoek Central Hospital (WCH) from 1998 to 2010. Demographic data, HIV profile, clinical picture of KS, and survival were documented. Results. The frequency of KS declined from 2006 to 2010 in TH but showed an increase in the same period in WCH. Children in TH were diagnosed at a much younger age than those in WCH (44.2 months versus 90 months). Cutaneous lesions were the most common clinical presenting feature, followed by lymphadenopathy, intrathoracic and oral lesions. Conclusions. The clinical characteristics of KS in South Africa and Namibia differ in many aspects between the 2 countries. 1. Introduction Kaposi Sarcoma (KS) is a low-grade malignant vascular tumor, with a viral etiology. The typical skin lesions were first described in 1872 [1] by Moritz Kaposi, a dermatologist from Hungary. While in most of the world the tumour was seen only sporadically, in regions from Central and Southern Africa it was found to be endemic, with incidence comparable to those of the cancer of the colon in resource-rich countries [2]. A dramatic increase in the incidence of this malignancy worldwide was associated with the HIV-AIDS epidemic, to the extent where KS became one of the AIDS-defining diseases. To distinguish it from the other known forms of the disease, that is, sporadic and endemic, when associated with AIDS, KS was said to be epidemic. The etiological agent, KS herpes virus (KSHV), was only discovered in 1994, as a result of the work by Chang and collaborators [3], who isolated and characterized the agent from tissue samples of epidemic KS. KSHV is endemic in Central and Southern Africa. In South Africa, a study of seroprevalence of the virus found that 15.9% of healthy children were infected, while in those living with HIV the prevalence was 28.6% [4]. This prevalence explains why, with the advent of the HIV epidemic, the incidence of KS soared to previously unknown levels. The odds ratio for the association
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