KAPOSI'S SARCOMA
Identifieur interne : 00A338 ( Main/Exploration ); précédent : 00A337; suivant : 00A339KAPOSI'S SARCOMA
Auteurs : Pere Gascn ; Robert A. SchwartzSource :
- Dermatologic Clinics [ 0733-8635 ] ; 2000.
Abstract
In the United States, Kaposi's sarcoma (KS) occurs in approximately 48 of homosexual men with HIV infection and in 1 to 5 of other persons with HIV infection.32 After 20 years of experience with the acquired immunodeficiency syndrome (AIDS) epidemic, the reason for these significant differences are not known. It is not known for certain, but it is most likely due to the high prevalence of human herpesvirus-8 (HHV-8), also known as Kaposi's sarcoma associated herpesvirus, within the male homosexual population.18 Kaposi's sarcoma is a systemic disease that often is first evident as cutaneous violacous patches, plaques, or nodules. In general, KS is asymptomatic, although visceral involvement occurs in about one half of the patients. Lung involvement occurs in 20 of the patients and is the most life-threatening form of the disease.10 During the last few years, investigators have begun to unravel the pathogenesis of KS, and new therapies have been developed as a result of the new understanding. These therapies include the use of inhibitors of angiogenesis, retinoids, and antiviral agents that act against the KS-associated viruses HHV-8. The remarkable results seen with the new antiretroviral therapy known as highly active anti-HIV therapy, or HAART, when used alone in patients with early AIDS-related KS (AIDS-KS), favors a first-line of therapy for KS focused on HIV therapy.30 Furthermore, it has been shown that HAART significantly reduces the risk of developing new KS. For this reason, decisions regarding treatment must be individualized and based on parameters predictive of treatment tolerance, likelihood of response, bone marrow reserve, and survival, among other factors. It must be remembered that KS therapy for AIDS patients may be only palliative, and that immunosuppressive favors proliferation of KS. Therefore, systemic chemotherapy should be reserved for patients with extensive disease who have already failed to respond to antiretroviral therapy.
Url:
DOI: 10.1016/S0733-8635(05)70157-1
Affiliations:
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