PMID- 23578530
OWN - NLM
STAT- MEDLINE
DCOM- 20131211
LR  - 20181202
IS  - 1873-5967 (Electronic)
IS  - 1386-6532 (Linking)
VI  - 57
IP  - 3
DP  - 2013 Jul
TI  - Successful treatment of an HIV-positive patient with unmasking Kaposi's sarcoma 
      immune reconstitution inflammatory syndrome.
PG  - 282-5
LID - S1386-6532(13)00088-7 [pii]
LID - 10.1016/j.jcv.2013.03.005 [doi]
AB  - BACKGROUND: Kaposi's sarcoma (KS) continues to be the most common human 
      immunodeficiency virus (HIV)-associated neoplasm with considerable morbidity and 
      mortality. While lesions normally resolve upon initiation of antiretroviral 
      therapy (ART), recrudescence or unmasking of KS lesions may occur as part of 
      immune reconstitution inflammatory syndrome (IRIS). Treatment of unmasking 
      KS-IRIS is not yet standardised. OBJECTIVES: To report the successful treatment 
      of a patient with fulminating mucocutaneous unmasking KS-IRIS by maintaining ART 
      and using pegylated liposomal doxorubicin (PLD). STUDY DESIGN: The patient, a 
      39-year-old HIV-positive male with no previous history of KS presented with a 
      2-week history of cutaneous and oral KS lesions that had disseminated rapidly 
      over the preceding 4 days. The KS lesions appeared 8 weeks after recommencing 
      ART. At the time of this presentation, his CD4+ count was 742 cells/mm(3) with a 
      HIV viral load <400 copies/ml. ART was maintained and treatment with PLD 
      commenced. RESULTS: Despite the rapid dissemination of KS lesions, virus was 
      undetectable in plasma. In a late-stage vasoformative lesion, 
      immunohistochemistry (IHC) for human herpesvirus 8 (HHV-8) antigen was light and 
      diffuse, with stippled deposits within endothelial cell nuclei. Virus extracted 
      from the lesion was HHV-8 subtype A. The patient responded well to PLD, relapsed 
      a year later, but after further PLD, has remained well for the following 5 years. 
      CONCLUSION: Despite the absence of HHV-8 viraemia, this is clearly a case of 
      unmasking KS-IRIS. It demonstrates that this entity can be successfully treated 
      by maintaining ART and administering PLD.
CI  - Copyright (c) 2013 Elsevier B.V. All rights reserved.
FAU - Speicher, David J
AU  - Speicher DJ
AD  - School of Dentistry and Oral Health, Griffith University, Queensland, Australia. 
      d.speicher@griffith.edu.au
FAU - Sehu, Marjoree M
AU  - Sehu MM
FAU - Johnson, Newell W
AU  - Johnson NW
FAU - Shaw, David R
AU  - Shaw DR
LA  - eng
SI  - GENBANK/JN613419
PT  - Case Reports
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130408
PL  - Netherlands
TA  - J Clin Virol
JT  - Journal of clinical virology : the official publication of the Pan American 
      Society for Clinical Virology
JID - 9815671
RN  - 0 (Anti-Retroviral Agents)
RN  - 0 (Antibiotics, Antineoplastic)
RN  - 0 (DNA, Viral)
RN  - 0 (liposomal doxorubicin)
RN  - 3WJQ0SDW1A (Polyethylene Glycols)
RN  - 80168379AG (Doxorubicin)
SB  - IM
MH  - Adult
MH  - Anti-Retroviral Agents/*administration & dosage
MH  - Antibiotics, Antineoplastic/*administration & dosage
MH  - CD4 Lymphocyte Count
MH  - DNA, Viral/chemistry/genetics
MH  - Doxorubicin/administration & dosage/*analogs & derivatives
MH  - Drug Therapy, Combination/methods
MH  - Genotype
MH  - HIV Infections/complications/*drug therapy
MH  - Herpesvirus 8, Human/classification/genetics/isolation & purification
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*drug therapy/pathology
MH  - Male
MH  - Molecular Sequence Data
MH  - Plasma/virology
MH  - Polyethylene Glycols/administration & dosage
MH  - Sarcoma, Kaposi/complications/*drug therapy/pathology
MH  - Sequence Analysis, DNA
MH  - Treatment Outcome
MH  - Viral Load
EDAT- 2013/04/13 06:00
MHDA- 2013/12/16 06:00
CRDT- 2013/04/13 06:00
PHST- 2012/10/16 00:00 [received]
PHST- 2013/03/06 00:00 [revised]
PHST- 2013/03/10 00:00 [accepted]
PHST- 2013/04/13 06:00 [entrez]
PHST- 2013/04/13 06:00 [pubmed]
PHST- 2013/12/16 06:00 [medline]
AID - S1386-6532(13)00088-7 [pii]
AID - 10.1016/j.jcv.2013.03.005 [doi]
PST - ppublish
SO  - J Clin Virol. 2013 Jul;57(3):282-5. doi: 10.1016/j.jcv.2013.03.005. Epub 2013 Apr 
      8.