Kaposi’s Sarcoma in the Era of ART: A Single Institutional Retrospective Review
Corresponding AuthorMark Agulnik
Department of Medicine at Northwestern University, Chicago, IL, USA
A B S T R A C T
Background: Kaposi’s Sarcoma (KS) is an angioproliferative tumor characterized by 4 sub-types: classic (CKS), endemic, immunosuppression related, and epidemic (AIDS-KS). AIDS-KS prevalence has decreased since the introduction of potent combination anti-retroviral therapy (ART). Even so, KS lesions develop in patients with undetectable viral loads and high CD4 counts. KS is variable across its subtypes, disease course, and clinical outcomes. Treatment must therefore be individualized. Results: 130 patients with a diagnosis of KS were identified, of which 95 (73.1%) had AIDS-KS and 31 (23.8%) had CKS. There were 4 patients with immunosuppression therapy-related KS and no endemic cases. 18.9% of AIDS-KS patients had metastatic disease vs. 6.5% in the CKS group. At KS diagnosis, 50.5% of AIDS-KS patients had CD4 count >200 cells/mm3 and 33.7% had HIV viral load level <=20 copies/mL. Among the 53 patients who received chemotherapy, 45 were AIDS-KS patients (84.9%). The most commonly used chemotherapy was doxorubicin hydrochloride liposomal injection (78.4%) with an average of 10 cycles. Other chemotherapy utilized includes paclitaxel and interferon. 16 pts (12.3%) died, of which only two died of disseminated AIDS-KS. Conclusions: Our retrospective study confirms that 75% of pts diagnosed with KS have AIDS-KS. Despite introduction of ART and the well-controlled nature HIV/AIDS, KS continues to occur. AIDS-KS patients are younger, more likely to have metastatic disease and more frequently treated with chemotherapy. Poorly controlled HIV confers a worse outcome in AIDS-KS. Further investigations are required to better understand the etiology of AIDS-KS in pts with undetectable HIV viral loads and immune recovery.
Article TypeResearch Article
Publication historyReceived: Tue 07, Jan 2020
Accepted: Sat 01, Feb 2020
Published: Mon 10, Feb 2020
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