PMID- 16051964
OWN - NLM
STAT- MEDLINE
DCOM- 20050914
LR  - 20220330
IS  - 0732-183X (Print)
IS  - 0732-183X (Linking)
VI  - 23
IP  - 22
DP  - 2005 Aug 1
TI  - Immune reconstitution inflammatory syndrome associated with Kaposi's sarcoma.
PG  - 5224-8
AB  - PURPOSE: A proportion of patients with HIV infection who subsequently receive 
      highly active antiretroviral therapy (HAART) exhibit a deterioration in their 
      clinical status, despite control of virologic and immunologic parameters. This 
      clinical response, known as the immune reconstitution inflammatory syndrome 
      (IRIS), occurs secondary to an immune response against previously diagnosed 
      pathogens. PATIENTS AND METHODS: From our cohort of 5,832 patients treated in the 
      HAART era, we identified 150 therapy-naive patients with a first presentation of 
      Kaposi's sarcoma (KS). Their clinicopathologic features and progress were 
      recorded prospectively. RESULTS: After commencing HAART, ten patients (6.6%) 
      developed progressive KS, which we identify as IRIS-associated KS. In a 
      comparison of these individuals with those whose KS did not progress, we found 
      that IRIS-KS occurred in patients with higher CD4 counts (P = .03), KS-associated 
      edema (P = .01), and therapy with both protease inhibitors and non-nucleosides 
      together (P = .03). Time to treatment failure was similar for both groups, 
      although the CD4 count declined more rapidly at first, in those patients with 
      IRIS-associated KS. Despite this initial decline, in our clinical experience 
      HAART could be successfully continued in those with IRIS-associated KS. 
      CONCLUSION: We have identified IRIS-KS in a cohort of HIV patients with KS who 
      start HAART.
FAU - Bower, M
AU  - Bower M
AD  - Department of Oncology, Chelsea and Westminster Hospital, London SW10 9NH, UK. 
      m.bower@ic.ac.uk
FAU - Nelson, M
AU  - Nelson M
FAU - Young, A M
AU  - Young AM
FAU - Thirlwell, C
AU  - Thirlwell C
FAU - Newsom-Davis, T
AU  - Newsom-Davis T
FAU - Mandalia, S
AU  - Mandalia S
FAU - Dhillon, T
AU  - Dhillon T
FAU - Holmes, P
AU  - Holmes P
FAU - Gazzard, B G
AU  - Gazzard BG
FAU - Stebbing, J
AU  - Stebbing J
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Clin Oncol
JT  - Journal of clinical oncology : official journal of the American Society of 
      Clinical Oncology
JID - 8309333
SB  - IM
MH  - Adult
MH  - *Antiretroviral Therapy, Highly Active
MH  - CD4 Lymphocyte Count
MH  - Cohort Studies
MH  - Disease Progression
MH  - Female
MH  - Humans
MH  - *Inflammation
MH  - Male
MH  - Middle Aged
MH  - Sarcoma, Kaposi/*complications/*immunology
MH  - Syndrome
EDAT- 2005/07/30 09:00
MHDA- 2005/09/15 09:00
CRDT- 2005/07/30 09:00
PHST- 2005/07/30 09:00 [pubmed]
PHST- 2005/09/15 09:00 [medline]
PHST- 2005/07/30 09:00 [entrez]
AID - 23/22/5224 [pii]
AID - 10.1200/JCO.2005.14.597 [doi]
PST - ppublish
SO  - J Clin Oncol. 2005 Aug 1;23(22):5224-8. doi: 10.1200/JCO.2005.14.597.