Long-term clinical outcome of AIDS-related Kaposi's sarcoma during highly active antiretroviral therapy

Anna Maria Cattelan, Maria Luisa Calabrò, Anita De Rossi, Savina Maria Luciana Aversa, Massimo Barbierato, Marco Trevenzoli, Paola Gasperini, Marisa Zanchetta, Paolo Cadrobbi, Silvio Monfardini, Luigi Chieco-Bianchi

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Abstract

The long-term impact of highly active antiretroviral therapy (HAART) in AIDS patients with Kaposi's sarcoma (KS) was evaluated in 22 consecutive, HAART-naïve KS patients attending a single Italian referral centre for HIV/AIDS. Clinical, virologic and immunologic responses to HAART were assessed at baseline and every three months during the follow-up. Peripheral blood mononuclear cell (PBMC)-associated human herpesvirus 8 (HHV-8) load was also evaluated by real-time PCR in 13 patients with durable clinical KS complete response (CR). In a median follow-up of 40 months (range 17-78), the KS overall clinical response rate was 91%: 18 complete and 2 partial responses were achieved, and two patients experienced disease progression. CR persisted in all 18 patients, including the 5 poor-risk KS patients in whom CR lasted for >60 months, and was significantly linked to an increase in CD4+ cell counts and a drop in HIV-1-RNA copies. Compared to baseline levels, a decrease in PBMC HHV-8 load was observed at CR, and a significant further reduction was found at the end of follow-up. In this monocentric study, AIDS-KS patients treated with HAART showed high clinical response rate. Patients with CR showed a prolonged remission, lasting more than 5 years in a group of poor-risk patients, and a persistent reduction in circulating HHV-8-infected cells. These findings highlight that HAART deeply modifies the natural history of this tumour in AIDS patients, and that this long-lasting approach may be considered a first-line treatment for the majority of HIV-1-infected patients developing KS.

Original languageEnglish
Pages (from-to)779-785
Number of pages7
JournalInternational Journal of Oncology
Volume27
Issue number3
Publication statusPublished - Sep 2005

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Keywords

  • HAART
  • HHV-8
  • HIV-1
  • Kaposi's sarcoma
  • Long-term follow-up

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Cattelan, A. M., Calabrò, M. L., De Rossi, A., Aversa, S. M. L., Barbierato, M., Trevenzoli, M., Gasperini, P., Zanchetta, M., Cadrobbi, P., Monfardini, S., & Chieco-Bianchi, L. (2005). Long-term clinical outcome of AIDS-related Kaposi's sarcoma during highly active antiretroviral therapy. International Journal of Oncology, 27(3), 779-785.