The influence of highly active antiretroviral therapy on AIDS-associated Kaposi's sarcoma

To assess the clinical and biological benefit of highly active antiretrovir al therapy on AIDS-associated Kaposi's sarcoma (KS), 13 patients with AIDS- associated Kaposi's sarcoma (five pulmonary KS and eight cutaneous KS) were prospectively followed for a mean duration of 12 months. Six patients were treated with specific anti-KS chemotherapy before or simultaneously with t he introduction of antiretroviral therapy. Clinical response was assessed a ccording to the AIDS Clinical Trial Group (ACTG) criteria. CD4 cell counts, plasma HIV-1 RNA and human herpesvirus 8 (HHV-8) viraemia were measured at baseline and at different points, Among patients with pulmonary KS, we obs erved three complete responses (CR), one partial response (PR) and one prog ression. The median survival time after the diagnosis of pulmonary KS was 1 5 months with a median duration of the response after the discontinuation o f specific chemotherapy for KS of 8 months, Among patients with cutaneous K S, we observed four CR, three PR and one stable response. A complete respon se was significantly associated with a reversal in HHV-8 viraemia (five of six vs. one of six; P = 0.02, Mann-Whitney test).