PMID- 16232048
OWN - NLM
STAT- MEDLINE
DCOM- 20051201
LR  - 20220409
IS  - 1087-2914 (Print)
IS  - 1087-2914 (Linking)
VI  - 19
IP  - 10
DP  - 2005 Oct
TI  - Recrudescent Kaposi's sarcoma after initiation of HAART: a manifestation of 
      immune reconstitution syndrome.
PG  - 635-44
AB  - The objective of this case series and literature review is to characterize the 
      clinical course and prognosis of HIV-infected patients with Kaposi's sarcoma (KS) 
      flare during immune reconstitution inflammatory syndrome (IRIS), a heterogeneous 
      and sometimes fatal disorder of immune perturbation after initiation of highly 
      active antiretroviral therapy (HAART). Medical records of 9 HIV-infected patients 
      with KS flare after virologic and immunologic response to HAART were reviewed 
      from a single institution. An additional 10 cases were abstracted by computerized 
      search of the medical literature. In our single institution series, mean time to 
      onset of KS flare was 5 weeks. Pretreatment mean CD4+ count was 190 cells/mm(3) 
      and mean HIV viral load was 153,934 copies per milliliter. During flare, mean 
      CD4+ count was 256 cells/mm(3) and mean HIV viral load was 1156 copies per 
      milliliter. Similar aggregate results are represented in the literature. Six 
      fatalities are reported, 4 from pulmonary KS and 2 from unrelated causes. 
      Systemic chemotherapy universally led to tumor regression, but was administered 
      in only 10 of 19 cases. In no instance was HAART discontinued. Onset of 
      IRIS-associated KS flare is observed as early as 3 weeks, with most cases 
      diagnosed within 2 months after immunologic and virologic response to HAART. Such 
      a flare does not necessarily portend a poor prognosis. Even for those patients 
      with rapidly symptomatic KS, early systemic chemotherapy is effective in 
      suppressing IRIS-associated flare. Close clinical supervision is warranted for 
      the KS patient initiating, changing, or resuming HAART. Particular vigilance is 
      recommended for pulmonary involvement.
FAU - Leidner, Rom S
AU  - Leidner RS
AD  - Division of General Internal Medicine, University of Washington, Seattle, 
      Washington, USA.
FAU - Aboulafia, David M
AU  - Aboulafia DM
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
PL  - United States
TA  - AIDS Patient Care STDS
JT  - AIDS patient care and STDs
JID - 9607225
MH  - AIDS-Related Opportunistic Infections/drug therapy/*immunology
MH  - Adult
MH  - *Antiretroviral Therapy, Highly Active
MH  - Disease Progression
MH  - HIV Infections/complications/*drug therapy/virology
MH  - HIV-1/drug effects
MH  - Humans
MH  - *Inflammation
MH  - Male
MH  - Sarcoma, Kaposi/*complications/*immunology
MH  - Syndrome
RF  - 19
EDAT- 2005/10/20 09:00
MHDA- 2005/12/13 09:00
CRDT- 2005/10/20 09:00
PHST- 2005/10/20 09:00 [pubmed]
PHST- 2005/12/13 09:00 [medline]
PHST- 2005/10/20 09:00 [entrez]
AID - 10.1089/apc.2005.19.635 [doi]
PST - ppublish
SO  - AIDS Patient Care STDS. 2005 Oct;19(10):635-44. doi: 10.1089/apc.2005.19.635.