PMID- 35205734 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220301 IS - 2072-6694 (Print) IS - 2072-6694 (Electronic) IS - 2072-6694 (Linking) VI - 14 IP - 4 DP - 2022 Feb 16 TI - Immune Reconstitution Inflammatory Syndrome Associated Kaposi Sarcoma. LID - 10.3390/cancers14040986 [doi] LID - 986 AB - People living with HIV (PLWH) with advanced immunosuppression who initiate antiretroviral therapy (ART) are susceptible to the occurrence of an immune reconstitution inflammatory syndrome (IRIS). Although ART is responsible for AIDS- associated Kaposi sarcoma (KS) improvement and resolution, new onset (unmasking KS-IRIS) or sudden progression of preexisting KS (paradoxical KS-IRIS) can occur after a time delay of between a few days and 6 months after the initiation or resumption of ART, even in patients with a low degree of immunocompromise. KS-IRIS incidence varies from 2.4% to 39%, depending on study design, populations, and geographic regions. Risk factors for developing KS-IRIS include advanced KS tumor stage (T1), pre-treatment HIV viral load >5 log(10) copies/mL, detectable pre-treatment plasma-KSHV, and initiation of ART alone without concurrent chemotherapy. Both paradoxical and unmasking KS-IRIS have been associated with significant morbidity and mortality, and thrombocytopenia (<100,000 platelets/mm(3) at 12 weeks) has been associated with death. KS-IRIS is not to be considered as ART failure, and an ART regimen must be pursued. Systemic chemotherapy for KS in conjunction with ART is recommended and, in contrast with management of IRIS for other opportunistic infections, glucocorticoids are contra-indicated. Despite our preliminary results, the place of targeted therapies in the prevention or treatment of KS-IRIS needs further assessment. FAU - Poizot-Martin, Isabelle AU - Poizot-Martin I AD - Assistance Publique-Hopitaux de Marseille (APHM), Inserm, Institut de Recherche pour le Developpement (IRD), SESSTIM, Sciences Economiques & Sociales de la Sante & Traitement de l'Information Medicale, ISSPAM, APHM Sainte-Marguerite, Service D'immuno-Hematologie Clinique, Aix-Marseille Universite, 13009 Marseille, France. FAU - Bregigeon, Sylvie AU - Bregigeon S AUID- ORCID: 0000-0002-2735-7793 AD - Assistance Publique-Hopitaux de Marseille (APHM) Sainte-Marguerite, Service D'immuno-Hematologie Clinique, Aix-Marseille Universite, 13009 Marseille, France. FAU - Palich, Romain AU - Palich R AUID- ORCID: 0000-0003-0047-0101 AD - Department of Infectious Diseases, Pitie-Salpetriere Hospital, Assistance Publique-Hopitaux de Paris (APHP), Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM U1136, Sorbonne University, 75013 Paris, France. FAU - Marcelin, Anne-Genevieve AU - Marcelin AG AUID- ORCID: 0000-0003-4808-8999 AD - INSERM, Institut Pierre Louis d'Epidemiologie et de Sante Publique (iPLESP), AP-HP, Hopital Pitie Salpetriere, Service de Virologie, Sorbonne Universite, 75013 Paris, France. FAU - Valantin, Marc-Antoine AU - Valantin MA AD - Department of Infectious Diseases, Pitie-Salpetriere Hospital, Assistance Publique-Hopitaux de Paris (APHP), Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM U1136, Sorbonne University, 75013 Paris, France. FAU - Solas, Caroline AU - Solas C AD - Assistance Publique-Hopitaux de Marseille (APHM), Hopital La Timone, Laboratoire de Pharmacocinetique et Toxicologie, INSERM 1207, IRD 190, Unite des Virus Emergents, Aix-Marseille Universite, 13005 Marseille, France. FAU - Veyri, Marianne AU - Veyri M AD - Department of Medical Oncology, Pitie Salpetriere Hospital, Assistance Publique-Hopitaux de Paris (APHP), Institut Universitaire de Cancerologie (IUC), CLIP2 Galilee, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM U1136, Sorbonne Universite, 75013 Paris, France. FAU - Spano, Jean-Philippe AU - Spano JP AD - Department of Medical Oncology, Pitie Salpetriere Hospital, Assistance Publique-Hopitaux de Paris (APHP), Institut Universitaire de Cancerologie (IUC), CLIP2 Galilee, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM U1136, Sorbonne Universite, 75013 Paris, France. FAU - Makinson, Alain AU - Makinson A AD - Centre Hospitalier Universitaire de Montpellier, Departement des Maladies Infectieuses et Tropicales, INSERM U1175/IRD UMI 233, 34000 Montpellier, France. LA - eng PT - Journal Article PT - Review DEP - 20220216 PL - Switzerland TA - Cancers (Basel) JT - Cancers JID - 101526829 PMC - PMC8869819 OTO - NOTNLM OT - AIDS OT - HIV OT - IRIS OT - Kaposi sarcoma OT - immune reconstitution inflammatory syndrome OT - target therapies COIS- Isabelle Poizot-Martin: consultancies (Gilead Sciences, MSD), travel/accommodation/meeting expenses (Gilead sciences, ViiVhealthcare), outside the submitted work. Sylvie Bregigeon: congress grants (ViiV, Healthcare), consultancies (ViiV Healthcare, Gilead, Janssen, MSD), outside the submitted work. Romain Palich has declared no conflict of interest with the submitted work. Anne-Genevieve Marcelin: consultancies (Gilead Sciences, VIIV Healthcare, MSD, Theratechnologies), research grants (Gilead sciences, ViiV Healthcare, MSD), outside the submitted work. Marc-Antoine Valantin has declared no conflict of interest with the submitted work. Caroline Solas has declared no conflict of interest with the submitted work. Marianne Veyri has declared no conflict of interest with the submitted work. Jean-Philippe Spano has no direct conflict of interest but received an honorarium as a consultant for Roche, MSD and Biogaran and has received a speaker honorarium from MSD, Roche, AstraZeneca, Leopharma, Mylan, Pfizer, BMS, Novartis, PFO, Myriads, Gilead and Lilly. Alain Makinson: travel grants (MSD, Mylan; Donations (MSD), outside the submitted work. The other authors declare no conflict of interest. EDAT- 2022/02/26 06:00 MHDA- 2022/02/26 06:01 PMCR- 2022/02/16 CRDT- 2022/02/25 01:07 PHST- 2021/11/29 00:00 [received] PHST- 2022/01/28 00:00 [revised] PHST- 2022/02/09 00:00 [accepted] PHST- 2022/02/25 01:07 [entrez] PHST- 2022/02/26 06:00 [pubmed] PHST- 2022/02/26 06:01 [medline] PHST- 2022/02/16 00:00 [pmc-release] AID - cancers14040986 [pii] AID - cancers-14-00986 [pii] AID - 10.3390/cancers14040986 [doi] PST - epublish SO - Cancers (Basel). 2022 Feb 16;14(4):986. doi: 10.3390/cancers14040986.