High CD4 cells count in a naïve HIV-infected patient with disseminated Kaposi sarcoma

Kaposi sarcoma (KS) is known to be one of the three AIDS-defining neoplasms together with non-Hodgkin lymphoma and cervical carcinoma. Since the beginning of AIDS epidemics, KS has been frequently diagnosed as a skin or mucous tumour accompanied by a low CD4 count due to advanced HIV infection. In our report, we describe the case of KS diagnosed in an ART-naïve patient with a high CD4 cell count, who presents tissue changes on the hard palate and in the gastrointestinal tract, and finally skin changes. Diagnostic problems due to unreliable biopsy results and an aggressive form of KS involving several organs both complicated the procedures and delayed treatment. In conclusion, KS should be taken into consideration in differential diagnosis even in patients with a high CD4 count.