HIV/AIDS-Related Kaposi Sarcoma: Kaposi sarcoma remission associated with HIV suppression and is independent of PI therapy

AIDSWEEKLY Plus; Monday, June 5, 2006
Staff Medical Writers

According to a recent report from France, "Highly active antiretroviral therapy (HAART) reduces the incidence and improves the prognosis of Kaposi's sarcoma (KS). This study was designed to identify factors associated with KS clinical responses in HIV-infected patients during HAART."

"We reviewed the files of 138 HIV-1-infected patients with KS. Epidemiologic and HIV-related clinical and biological parameters were recorded at KS diagnosis (baseline) and every 6 months thereafter.

"In a subset of 73 antiretroviral-naive patients, we compared the clinical outcome of KS according to the use or nonuse of protease inhibitors (PI)," wrote V. Martinez and colleagues at the University Paris 06.

"After 6 months of follow-up, KS remission was more frequent in patients who were naive of HAART and who were at ACTG stage S0 at baseline (p=0.03 and 0.02). Undetectable HIV viral load was strongly associated with KS remission (p<0.004 at all time points), while CD4 cell count was not.

"Among the 73 antiretroviral-naive patients at baseline, and who were studied for 24 months, KS outcome did not differ between patients who were prescribed PI-containing and PI-sparing regimens," researchers said.

The authors continued, "Intercurrent multicentric Castleman's disease was associated with poor outcome after 60 months of follow-up (Pless than or equal to0.0001). Fourteen deaths occurred after a median follow-up of 37.5 months, 8 of which were KS related."

Martinez concluded, "Suppression of HIV replication appears to be crucial to control KS. Non-PI-based regimens were equivalent to PI-based regimens as regards the clinical and virological outcome of antiretroviral-naive HIV-infected patients with KS."

Martinez and colleagues published their study in British Journal of Cancer (Remission from Kaposi's sarcoma on HAART is associated with suppression of HIV replication and is independent of protease inhibitor therapy. Br J Cancer. 2006 Apr 10;94(7):1000-6).

For additional information, contact V. Martinez, University of Paris 06, AP HP, Hop La Pitie Salpetriere, Dept. Maladies Infection & Trop, 45-83 Blvd. Hop, F-75013 Paris, France.

Publisher contact information for the British Journal of Cancer is: Nature Publishing Group, Macmillan Building, 4 Crinan St., London N1 9XW, England.

Keywords: Paris, France, HIV/AIDS, Kaposi Sarcoma, Viral Inhibition, Castleman's Disease, Clinical Outcome.

This article was prepared by AIDS Weekly editors from staff and other reports.

Reference

Martinez V, Caumes E, Gambotti L, et al., "Remission from Kaposi's sarcoma on HAART is associated with suppression of HIV replication and is independent of protease inhibitor therapy", Br J Cancer. 2006 Apr 10;94(7):1000-6.

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