PMID- 18251652
OWN - NLM
STAT- MEDLINE
DCOM- 20080318
LR  - 20080206
IS  - 0022-3492 (Print)
IS  - 0022-3492 (Linking)
VI  - 79
IP  - 2
DP  - 2008 Feb
TI  - Human immunodeficiency virus-associated Kaposi sarcoma as an immune 
      reconstitution inflammatory syndrome: a literature review and case report.
PG  - 362-8
LID - 10.1902/jop.2008.070225 [doi]
AB  - BACKGROUND: Kaposi sarcoma (KS) is the most common human immunodeficiency virus 
      (HIV)-associated neoplasm (HIV-KS). Highly active antiretroviral therapy (HAART) 
      results in a decrease in the incidence and prevalence of HIV-KS as well as in 
      clinical improvement. However, in a subset of subjects who are HIV seropositive, 
      KS may recrudesce early following the introduction of HAART as an immune 
      reconstitution inflammatory syndrome (IRIS). METHODS: The management of a patient 
      who is HIV seropositive with rapid clinical worsening of oral KS lesions shortly 
      after the initiation of HAART was documented. Repeated serologic testing for 
      CD4(+) T-cell count and microscopic examination of two biopsy specimens of the 
      oral lesion, one taken before and the other taken after cytotoxic chemotherapy, 
      followed by surgical excision was the treatment modality used. RESULTS: 
      Microscopic examination of the incisional biopsy specimen taken from the oral 
      lesion at the time of the initial consultation confirmed the clinical diagnosis 
      of KS. The sequential serological tests showed a progressive increase in CD4(+) 
      T-cell counts that paralleled the rapid clinical worsening of the KS disease. 
      This was consistent with the diagnosis of IRIS-associated HIV-KS. Subsequent 
      cytotoxic chemotherapy brought about resolution of the IRIS and regression of the 
      HIV-KS lesions. Microscopic examination of a biopsy specimen obtained after 
      cytotoxic chemotherapy did not show any of the original KS. The residual palatal 
      exophytic mass was excised. CONCLUSIONS: IRIS-associated HIV-KS is not a disease, 
      but rather a temporary paradoxical immunoinflammatory reaction brought about by 
      improvement in immune status following HAART. IRIS-associated HIV-KS can be 
      controlled effectively by limited systemic cytotoxic chemotherapy in the setting 
      of HAART.
FAU - Feller, Liviu
AU  - Feller L
AD  - Department of Periodontology and Oral Medicine, University of Limpopo, Medunsa 
      Campus, Medunsa, South Africa. lfeller@medunsa.ac.za
FAU - Anagnostopoulos, Christos
AU  - Anagnostopoulos C
FAU - Wood, Neil H
AU  - Wood NH
FAU - Bouckaert, Michael
AU  - Bouckaert M
FAU - Raubenheimer, Erich J
AU  - Raubenheimer EJ
FAU - Lemmer, Johan
AU  - Lemmer J
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
PL  - United States
TA  - J Periodontol
JT  - Journal of periodontology
JID - 8000345
RN  - 0 (Antineoplastic Agents)
SB  - IM
MH  - Adult
MH  - Antineoplastic Agents/therapeutic use
MH  - Antiretroviral Therapy, Highly Active/adverse effects
MH  - Female
MH  - HIV Infections/*complications/drug therapy
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/drug therapy/*etiology
MH  - Leukocyte Count
MH  - Palatal Neoplasms/drug therapy/*etiology/surgery
MH  - Sarcoma, Kaposi/drug therapy/*etiology/surgery
RF  - 18
EDAT- 2008/02/07 09:00
MHDA- 2008/03/19 09:00
CRDT- 2008/02/07 09:00
PHST- 2008/02/07 09:00 [pubmed]
PHST- 2008/03/19 09:00 [medline]
PHST- 2008/02/07 09:00 [entrez]
AID - 10.1902/jop.2008.070225 [doi]
PST - ppublish
SO  - J Periodontol. 2008 Feb;79(2):362-8. doi: 10.1902/jop.2008.070225.