KAPOSI'S SARCOMA IN THE SETTING OF THE AIDS PANDEMIC

Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.

KAPOSI'S SARCOMA IN THE SETTING OF THE AIDS PANDEMIC

AIDS: Modern Concepts and Therapeutic Challenges. Broder S, ed. New York, Marcel Dekker, p. 219-32, 1987.. Unique Identifier : AIDSLINE ICDB/89650444
Gelmann EP; Broder S; Medicine Branch, Clinical Oncology Program, NCI, Bethesda, MD

Abstract: Kaposi's sarcoma (KS) associated with AIDS and human T-lymphotropic virus-III/lymphadenopathy-associated virus (HTLV-III/LAV) infection is reviewed. The occurrence of the disorder is restricted to four well-defined groups, in each of which KS appears to follow a different clinical course: (1) African KS (before the advent of AIDS), (2) classical KS, (3) KS associated with immunosuppressive drug therapy, and (4) KS in AIDS patients (pts). Since KS is not equally prevalent among those at high risk for AIDS, but has a marked predominance among male homosexuals, there appear to be cofactors affecting the development of KS in the setting of AIDS. The proportion of KS in homosexual men with HTLV-III/LAV infection (the risk group with the largest number of cases) may be decreasing compared with the number of cases of Pneumocystis pneumonia. In the subset of these pts, KS causes substantial and life-threatening morbidity. It is unclear whether, in AIDS pts who have had chronic KS, the lesions would disappear automatically if new therapies were able to reverse the immunodeficiency. Experience with the transplant pt whose KS resolves when immunosuppressive therapy is stopped at the first appearance of a KS lesion may not be applicable to the AIDS pt who has extensive KS. It appears that a definitive therapy for KS in the setting of AIDS will depend on the development of effective strategies for restoring the immunological capacity of the pt with AIDS and suppressing the retrovirus. (64 Refs)

Keywords: Acquired Immunodeficiency Syndrome/*COMPLICATIONS/EPIDEMIOLOGY Africa Antineoplastic Agents, Combined/THERAPEUTIC USE Cross-Sectional Studies *Disease Outbreaks Human Immunosuppressive Agents/ADVERSE EFFECTS Prognosis Risk Factors Sarcoma, Kaposi's/DRUG THERAPY/EPIDEMIOLOGY/*ETIOLOGY Skin Neoplasms/DRUG THERAPY/EPIDEMIOLOGY/*ETIOLOGY MONOGRAPH REVIEW REVIEW, TUTORIAL

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