AIDS-related Kaposi Research Articles

Mortality and Associated Risk Factors Among People Living With HIV With Kaposi Sarcoma: A5263/AMC066 and A5264/AMC067.

AIDS-related Kaposi sarcoma (AIDS-KS) remains a leading cause of morbidity and mortality among people living with HIV in Africa. Mortality among people with AIDS-KS on antiretroviral therapy remains high compared with people on antiretroviral therapy who do not have AIDS-KS. People living with HIV with Kaposi sarcoma (KS) who participated in 2 randomized trials (A5263/AMC066 [advanced stage] and A5264/AMC067 [mild-to-moderate stage]) conducted by AIDS Clinical Trials Group/AIDS Malignancy Consortium in low- and middle-income countries. We estimated mortality rates over the trial period. Cox proportional hazards regressions were used to identify baseline characteristics associated with mortality and compared mortality rates between participants who had KS progression within 12 weeks of treatment initiation (early progression of KS [KS-PD]) and those who did not. Of the 329 and 189 eligible participants in A5263/AMC066 and A5264/AMC067, 71 (21.6%) and 24 (12.7%) died, respectively. In both trials, hypoalbuminemia was associated with increased hazards of death compared with normal albumin; A5263/AMC066: mild hypoalbuminemia (adjusted hazard ratio [aHR] = 3.01; 95% CI: 1.42 to 6.29), moderate hypoalbuminemia (aHR = 5.11; 95% CI: 2.54 to 10.29), and severe hypoalbuminemia (aHR = 14.58; 95% CI: 6.32 to 35.60), and A5264/AMC067: mild hypoalbuminemia (aHR = 5.66; 95% CI: 1.90 to 16.93) and moderate hypoalbuminemia (aHR = 7.02; 95% CI: 2.57 to 19.15). The rate of death was higher among participants who had early KS-PD than those without early KS-PD in A5263/AMC066 (HR = 5.09; 95% CI: 1.71 to 15.19) but not in A5264/AMC067 (HR = 1.74; 95% CI: 0.66 to 4.62). Albumin measurements may be used to identify individuals at higher risk of death after initiating KS treatment and for evaluation of interventions that can reduce AIDS-KS mortality.

Retrospective evaluation of drug to drug interactions with paclitaxel use in military health.

e24118 Background: Paclitaxel is an antineoplastic agent used in the management of multiple metastatic and non-resectable tumor types approved for ovarian, breast, AIDS-related Kaposi sarcoma, non-small cell lung, pancreatic, cervical, endometrial, and thymoma or thymic carcinoma cancer by the US Food and Drug Administration. Cytochrome P450 (CYP) 3A4 or 2C8 inducers, inhibitors, or substrates may alter paclitaxel metabolism. Because DDIs can have an effect on clinical outcomes, we aimed to identify drugs that interact with paclitaxel and describe their clinical manifestations. Methods: A retrospective analysis was performed on the health records of patients in the US Department of Defense Cancer Registry (retrieved March 2022), Comprehensive Ambulatory/Professional Encounter Records, and Pharmacy Data Transaction Service database (both retrieved October 2022). Patients’ medical history, diagnoses, and demographics were extracted and analyzed for differences in adverse effects when these agents were used alone vs concomitantly with other prescription drugs. Patients’ diagnoses and prescription drug use were extracted to compare completed vs discontinued treatment groups, identify medications commonly co-administered with paclitaxel, and evaluate DDIs with antidepressants. Results: Of 702 patients using paclitaxel, 338 completed treatments. The P value for paclitaxel discontinuation when used alone vs concomitantly or 1 drug (alone or before or after) vs combination (2 to 4 drugs) was < .001. Patients who took paclitaxel concomitantly with a greater number of prescription drugs had a higher rate of treatment discontinuation than those who received fewer medications. Patients in the completed group received 9 to 56 prescription drugs, and those in the discontinued group were prescribed 6 to 70. Those who discontinued treatment had more diagnosed medical issues than those who completed treatment. Conclusions: This review cannot conclude that concomitant use with prescription drug(s) resulted in paclitaxel discontinuation. There were no significant DDIs determined between paclitaxel and antidepressants.[Table: see text]

Treatment outcomes of patients with classic and AIDS-related Kaposi Sarcoma: a single-center real-world experience.

The recommended first-line chemotherapy agents for managing Kaposi sarcoma (KS) in high-income countries are expensive and often unavailable in developing nations such as Peru. Limited data exist on whether management practices in these countries affect patient outcomes. We assessed the real-world treatment approaches and outcomes of patients with KS in Peru. We retrospectively reviewed the medical records of patients with acquired immunodeficiency syndrome-related KS (AIDS-related KS; n = 95) and classic KS (CKS; n = 81) diagnosed at a tertiary center between 2000 and 2014 in Lima, Peru. We used the Kaplan-Meier method to estimate overall survival (OS) rates. The median follow-up was 64months for AIDS-related KS and 88months for CKS. The median age of patients with AIDS-related KS was 35years (range 20-63years) and 70years (range 33-91years) for those with CKS. Most individuals had an Eastern Cooperative Oncology Group performance status of ≥ 2 (AIDS-related KS 75%; CKS 85%). Seventy-six percent and 40% of individuals with AIDS-related KS and CKS, respectively, received systemic chemotherapy. The most common first-line drug was paclitaxel, with relatively optimal overall response rates (ORRs) for AIDS-related KS (n = 64/72, 89%; ORR 61%) and CKS (n = 24/32, 75%; ORR 50%). The 5-year OS rates were 71% in the AIDS-related KS cohort and 81% in the CKS cohort. The findings from this real-world study may inform clinical practices and highlight the need for increased access to effective treatments and clinical trials for patients with KS in Peru and other developing countries.

Prognostic factors for competing risk in patients with AIDS-related Kaposi's sarcoma: A SEER population-based study.

Despite the improved survival of patients with AIDS and Kaposi's sarcoma (KS), competing events are a non-negligible issue affecting the survival of such patients. In this study, we explored the prognostic factors of KS-specific and non-KS-specific mortality in patients with AIDS-related KS (AIDS-KS), accounting for competing risk. We identified 17 103 patients with AIDS-KS aged 18-65 years between 1980 and 2016 from the Surveillance, Epidemiology, and End Results (SEER) 18 registry database. Prognostic factors for KS-specific and non-KS-specific mortality were determined by the Fine and Grey proportional subdistribution hazard model. We built competing risk nomograms and assessed their predictive performance based on the identified prognostic factors. In total, 12 943 (75.68%) patients died, 1965 (15.50%) of whom died from competing events. The KS-specific mortality rate was 14 835 per 100 000 person-years, and the non-KS specific mortality rate was 2719 per 100 000 person-years. Specifically, age >44 years was associated with an 11% decrease in the subdistribution hazard of KS-specific mortality compared with age <43 years but a 50% increase in the subdistribution hazard of non-KS-specific mortality. Being male was associated with a 26% increase in the subdistribution hazard of KS-specific mortality compared with being female but a 32% decrease in the subdistribution hazard of non-KS-specific mortality. Notably, being in the antiretroviral therapy (ART) era consistently showed a decrease in the subdistribution hazard of both KS-specific and non-KS-specific mortality than being in the pre-ART era. Competing events commonly occurred among patients with AIDS-KS, which deserves further attention to improve the prognosis of these patients.

AIDS-related Kaposi sarcoma of the oral cavity.

AIDS-related Kaposi sarcoma of the oral cavity.

PULMONARY KAPOSI SARCOMA WITH ASSOCIATED RECURRENT CHYLOTHORAX

SESSION TITLE: Pneumothorax, Chylothorax, and Pleural Effusion Case PostersSESSION TYPE: Case Report PostersPRESENTED ON: 10/17/2022 12:15 pm - 01:15 pmINTRODUCTION: AIDS related Kaposi Sarcoma (KS) is an endothelial malignancy associated with HHV8 infection. It is the most common malignancy in patients with AIDS. Pulmonary KS is uncommon and rarely causes pleural effusions, particularly chylothorax. Here we present a case of recurrent chylothorax leading to diagnosis of pulmonary KS by pleural biopsy.CASE PRESENTATION: 40-year-old male with HIV/AIDS on HAART therapy and KS was referred for pleural effusion. He was previously treated with Doxil for gastrointestinal KS, but stopped due to neutropenia. He had persistent shortness of breath and occasional night sweats. A thoracentesis was performed, and fluid studies were consistent with a chylothorax. He had a recurrent pleural effusion two months later, and he underwent right sided pleuroscopy with pleural biopsies, talc pleurodesis, and tunneled pleural catheter placement. Diffuse hemorrhagic lesions throughout the right lung, and a raised plaque like lesion along the parietal pleura were seen during pleuroscopy. Biopsy of the parietal pleural was consistent with metastatic KS. He will discuss treatment with his oncologist.DISCUSSION: Pulmonary KS is uncommon and rarely causes pleural effusions, particularly chylothorax. Thoracoscopy is usually not needed to diagnose pulmonary KS as it should only affect visceral pleura. As in this case, thoracoscopy is typically used to assist with patient's symptoms and rule out other causes of an effusion. This is a rare case of KS causing chylothorax requiring thoracoscopy and biopsies for diagnosis.CONCLUSIONS: Here we present a case of pulmonary KS with accompanying chylothorax. This is not a typical presentation or path to diagnosis for pulmonary KS.Reference #1: Cherian S, Umerah OM, Tufail M, et al. Chylothorax in a patient with HIV-related Kaposi's sarcoma. BMJ Case Reports CP2019;12:e227641.Reference #2: Ramos A, Granado J, et al. Pulmonary Kaposi Sarcoma - An atypical clinical presentation. International Journal of Infectious Disease. 2022;115:185-188.Reference #3: Pandya K, Lal C, et al. Bilateral Chylothorax with Pulmonary Kaposi's Sarcoma. Chest. 1988;94(6):1316-1317.DISCLOSURES: No relevant relationships by Harshesh AminNo relevant relationships by Yanglin GuoNo relevant relationships by John HeneganNo relevant relationships by Rachel MullinsNo relevant relationships by Randolph Ross SESSION TITLE: Pneumothorax, Chylothorax, and Pleural Effusion Case Posters SESSION TYPE: Case Report Posters PRESENTED ON: 10/17/2022 12:15 pm - 01:15 pm INTRODUCTION: AIDS related Kaposi Sarcoma (KS) is an endothelial malignancy associated with HHV8 infection. It is the most common malignancy in patients with AIDS. Pulmonary KS is uncommon and rarely causes pleural effusions, particularly chylothorax. Here we present a case of recurrent chylothorax leading to diagnosis of pulmonary KS by pleural biopsy. CASE PRESENTATION: 40-year-old male with HIV/AIDS on HAART therapy and KS was referred for pleural effusion. He was previously treated with Doxil for gastrointestinal KS, but stopped due to neutropenia. He had persistent shortness of breath and occasional night sweats. A thoracentesis was performed, and fluid studies were consistent with a chylothorax. He had a recurrent pleural effusion two months later, and he underwent right sided pleuroscopy with pleural biopsies, talc pleurodesis, and tunneled pleural catheter placement. Diffuse hemorrhagic lesions throughout the right lung, and a raised plaque like lesion along the parietal pleura were seen during pleuroscopy. Biopsy of the parietal pleural was consistent with metastatic KS. He will discuss treatment with his oncologist. DISCUSSION: Pulmonary KS is uncommon and rarely causes pleural effusions, particularly chylothorax. Thoracoscopy is usually not needed to diagnose pulmonary KS as it should only affect visceral pleura. As in this case, thoracoscopy is typically used to assist with patient's symptoms and rule out other causes of an effusion. This is a rare case of KS causing chylothorax requiring thoracoscopy and biopsies for diagnosis. CONCLUSIONS: Here we present a case of pulmonary KS with accompanying chylothorax. This is not a typical presentation or path to diagnosis for pulmonary KS. Reference #1: Cherian S, Umerah OM, Tufail M, et al. Chylothorax in a patient with HIV-related Kaposi's sarcoma. BMJ Case Reports CP2019;12:e227641. Reference #2: Ramos A, Granado J, et al. Pulmonary Kaposi Sarcoma - An atypical clinical presentation. International Journal of Infectious Disease. 2022;115:185-188. Reference #3: Pandya K, Lal C, et al. Bilateral Chylothorax with Pulmonary Kaposi's Sarcoma. Chest. 1988;94(6):1316-1317. DISCLOSURES: No relevant relationships by Harshesh Amin No relevant relationships by Yanglin Guo No relevant relationships by John Henegan No relevant relationships by Rachel Mullins No relevant relationships by Randolph Ross

Characterization of a Mesoporous Silica Nanoparticle Formulation Loaded with Mitomycin C Lipidic Prodrug (MLP) and In Vitro Comparison with a Clinical-Stage Liposomal Formulation of MLP.

Nanomedicines have revolutionized the treatment of certain types of cancer, as is the case of doxil, liposomal formulation with doxorubicin encapsulated, in the treatment of certain types of ovarian cancer, AIDS-related Kaposi sarcoma, and multiple myeloma. These nanomedicines can improve the performance of conventional chemotherapeutic treatments, with fewer side effects and better efficiency against cancer. Although liposomes have been used in some formulations, different nanocarriers with better features in terms of stability and adsorption capabilities are being explored. Among the available nanoparticles in the field, mesoporous silica nanoparticles (MSNP) have attracted great attention as drug delivery platforms for the treatment of different diseases. Here, a novel formulation based on MSNP loaded with a potent antitumor prodrug that works in vitro as well as in a clinically evaluated liposomal formulation has been developed. This novel formulation shows excellent prodrug encapsulation efficiency and effective release of the anticancer drug only under certain stimuli typical of tumor environments. This behavior is of capital importance for translating this nanocarrier to the clinic in the near future.

Kaposi’s Sarcoma Trends in the Era of Highly Active Antiretroviral Therapy in Zambia

AIDS-related Kaposi’s Sarcoma (KS) is a multi-centric angiogenic neoplastic proliferation predominantly seen in individuals with Human Immune Virus (HIV-1) infection and men who have sex with men. Although the incidences of aggressive KS have reduced following the introduction of Highly Active Antiretroviral Therapy (HAART) in the treatment of HIV infection, the effect of HAART rollout in relation to population KS incidence in Zambia remains unclear as cases of the malignancy have continued to be reported. This study, investigated the trends of KS in the era of HAART in Zambia. The researchers conducted a retrospective cross-sectional study. Three hundred and twentycases of HIV-infected individuals on HAART that developed KS between 2008 and 2017 were reviewed. Data was retrieved from the Zambia National Cancer Registry (ZNCR). Of the records reviewed, the researchers observed a sharp increase in KS cases from 5.6 per cent in 2008 to 21.2 per cent in 2014; from 2015 to 2017, there was a general decline in KS cases countrywide in both sexes from 13.1 per cent to 9.4 per cent. KS was more prevalent in Lusaka Province, while Western Province had the least number of cases. For each province, there were more males affected by KS than females. The researchers further observed that 19.1 per cent of the cases reviewed developed KS while on HAART, while 80.9 per cent developed KS before the commencement of HAART. The age group with the highest number of KS cases was 21-40 years, while the age group ≥ 80 had the least number of cases. Our data has shown that although there has been a general decline in KS cases across the ten provinces of Zambia in recent years, more efforts are still required to mitigate AIDS-related KS incidence and improve KS prognosis. There is a need to encourage efforts aimed at HIV infection prevention, wide coverage of HAART across the country, and KS awareness and screening.

Treatments for AIDS/HIV-related Kaposi sarcoma: A systematic review of the literature.

Treatment guidelines are not well established in AIDS-related Kaposi sarcoma (KS). We aim to review the evidence on efficacy of treatments for AIDS-related Kaposi sarcoma. We searched the Cochrane Library, PubMed, and Embase Database from date of database inception till July 2020. Randomized controlled trials reporting intervention consisting of any type of treatment compared to control/placebo to a different treatment modality or different combination of treatment/treatment doses with a diagnosis of AIDS-related KS are selected. Primary outcomes were response rates defined as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD). Secondary outcomes were cosmesis and adverse outcomes such as pain and erythema. Thirteen out of 536 articles met our eligibility criteria. Three studies reported the efficacy of chemotherapy, two studies looked at different doses of radiotherapy regimes, and three studies compared different antiretroviral therapy (ART) and chemotherapy regimens. Other studies reported topical therapies such as alitretinoin gel, IM862, and bHCG injection which showed varied efficacies. Lack of standardization classification of disease activity and clinical outcomes and treatment modalities precluded meaningful comparison of studies. The evidence of efficacy of any particular intervention is overall varied and there was insufficient evidence to recommend any particular intervention. We have provided an overview of treatments for KS but larger studies need to be carried out to verify the efficacy of treatment options reported in the literature.

A Review on Formulation and Evaluation of Nanoniosomal Topical gel of Paclitaxel for skin cancer

Cancer is the second leading cause of death in the world and one of the major public health problems. Despite the great advances in cancer therapy, the incidence and mortality rates of cancer remain high. Therefore, the goal for more efficient and less toxic cancer treatment strategies is still at the forefront of current research. Despite these efforts, cancer drug research remains a remarkably challenging field, and therapeutic innovations have not yet achieved expected clinical results. However, the physiopathology of the disease is now better understood, and the discovery of novel molecular targets has refreshed the expectations of developing improved treatments. Paclitaxel (PCT) is a chemotherapeutic agent used as a first-line treatment for a wide range of cancers, such as lung, ovarian, breast, prostate, head, and neck cancers, and AIDS-related Kaposi sarcoma. Currently, the marketed forms of Paclitaxel are intravenous formulations. Oral administration of Paclitaxel is unfortunately hampered due to its low bioavailability. This is explained by its low aqueous solubility, low permeability, high affinity for cytochrome P450 and P-glycoprotein. As another approach, drug carrier systems are extensively studied to enhance oral Paclitaxel bioavailability and reduce side effects. The niosomes provides several important advantages over conventional drug therapy. Structurally, niosomes are similar to liposomes, in that they are also made up of a bilayer. However, the bilayer in the case of niosomes is made up of non-ionic surface-active agents rather than phospholipids as seen in case of liposomes. Niosome nanoparticles are among these drug delivery systems, which have numerous applications in drug delivery and targeting. Niosomes are frequently used for loading drugs serving different purposes (e.g., anticancer, antiviral, and antibacterial agents). The aim of this review is to evaluate the extent of nanotherapeutics used in anti-cancer activity.

AIDS-Related Kaposi Sarcoma in a 29-Year-Old Man Is Successfully Treated With Only Combination Antiretroviral Therapy

Liu, Jia-Shu1; Zhang, Lan2; Gao, Rong1; Zhu, Long-Fei1; Geng, Song-Mei1; Zhang, Yan-Fei1; Li, Zheng-Xiao1,* Author Information

M030 DESENSITIZATION AND STEPPED REINTRODUCTION IN ANAPHYLAXIS TO PEGYLATED LIPOSOMAL DOXORUBICIN IN KAPOSI'S SARCOMA

Pegylated liposomal doxorubicin (PLD) is a first line treatment approved for breast and ovarian cancers, multiple myeloma, and AIDS-related Kaposi sarcoma. Immediate hypersensitivity reactions (HSR) have been reported in 3-11% of patients2, but less than 1% are severe reactions that presented in the first minutes of infusion.

A UNIQUE PRESENTATION OF PULMONARY KAPOSI SARCOMA IN A YOUNG PATIENT WITH CONCOMITANT CMV

TOPIC: Chest Infections TYPE: Medical Student/Resident Case Reports INTRODUCTION: Kaposi sarcoma (KS) is an AIDS-defining illness characterized by low-grade vascular tumors thought to be caused by HHV-8. Commonly described features include raised purplish skin nodules millimeters to centimeters in size on the face, groin, and lower extremities (1). Less discussed are the visceral manifestations and the co-infections which may contribute to the presentation. Our case demonstrates a young male with pulmonary KS confirmed by imaging and bronchoscopy with biopsy found to have co-infection with CMV. CASE PRESENTATION: A 29-year-old male with AIDS-related cutaneous Kaposi sarcoma (diagnosed 11/2020) presented with dyspnea, cough, hemoptysis, and lower extremity edema in 2/2021. On arrival, vitals were stable with SpO2 98% on room air. Admission labs revealed CD4 of 17, HIV viral load <30, WBC 7.4 with 1% atypical lymphocytes, AST/ALT 101/84, and negative testing for SARS-CoV-2 and influenza A/B. Chest X-ray on admission showed patchy bilateral airspace disease. CTA chest showed bilateral peribronchovascular flame-shaped ground glass opacities, bilateral pulmonary nodules, mediastinal and axillary lymphadenopathy, and moderate bilateral pleural effusions. Right thoracentesis was performed with removal of 900mL of serosanguinous fluid exudative by Light's criteria. Subsequent diagnostic bronchoscopy showed areas of thickened erythematous mucosa with predominance in the bilateral upper lobes. Bronchoalveolar lavage (BAL) revealed CMV level of 224 IU/mL without additional infectious agents. Transbronchial and endobronchial biopsy revealed neoplastic cells positive for CD31 and HHV-8, confirming pulmonary parenchymal and endobronchial KS. Patient continued with HAART and was started on liposomal doxorubicin. DISCUSSION: This case describes a young male with AIDS and cutaneous KS who presented with productive cough, dyspnea, and hemoptysis found to have pulmonary KS. An interesting aspect of this case is the possible contribution of CMV co-infection. In addition to BAL findings, imaging was consistent with aspects of both KS and CMV including flame shaped GGOs and pulmonary nodules, respectively (2,3). Also demonstrated were labs consistent with CMV, including atypical lymphocytes and moderately elevated AST/ALT (6). Interestingly, there are publications from as early as 1980 suggesting that CMV may contribute to the development of KS by working synergistically with HHV-8 (4,5). A 2009 study even went on to postulate that a particular CMV locus can activate the full KS-associated herpesvirus lytic replication cycle (7). CONCLUSIONS: Our case presents a patient with KS and CMV co-infection. CMV may directly or indirectly influence the presentation of respiratory illness in co-infected patients. Though some work has been done already, future studies should work to further elucidate the exact association between KS and CMV in AIDS patients. REFERENCE #1: Reference #1: Aboulafia D.M. The epidemiologic, pathologic, and clinical features of AIDS-associated pulmonary Kaposi's sarcoma. Chest. 2000;117(4):1128–1145.Reference #2: Restrepo C et al. Imaging manifestations of Kaposi sarcoma. Radiographics. 2006;99(4).Reference #3: McGuinness G et al. Cytomegalovirus pneumonitis: spectrum of parenchymal CT findings with pathologic correlation in 21 AIDS patients. Radiology. 1994;192(2). REFERENCE #2: Reference #4: Giraldo G, Beth E, Huang E. Kaposi's sarcoma and its relationship to cytomegalovirus (CMNV). III. CMV DNA and CMV early antigens in Kaposi's sarcoma. Int J Cancer. 1980;26(1).Reference #5: Goldman, J.M., Epstein M.A. Vaccine intervention against virus-induced tumors. Palgrave Macmillan, London;c1986. 93-103p.Reference #6: Goncalves C et al. Cytomegalovirus acute infection with pulmonary involvement in an immunocompetent patient. ID Cases. 2018;14. REFERENCE #3: Reference #7: Wells R, Stensland L, Vieira J. The human cytomegalovirus UL112-113 locus can activate the full kaposi's sarcoma-associated herpesvirus lytic replica ion cycle. Journal of Virology. Apr 2009;83(9) 4695-4699p. DISCLOSURES: No relevant relationships by Jacob Patrick, source=Web Response No relevant relationships by Yiseiry Perez-Melendez, source=Web Response

Treatment of AIDS-related Kaposi's Sarcoma With Low-dose Radiotherapy - Follow-up on 2,305 Tumours.

We aimed to report our experience obtained by treating AIDS-related Kaposi's sarcoma (KS) with radiotherapy before the era of antiretroviral therapy. This investigation was performed as a quality control of KS patients treated with low-dose radiotherapy at our department. KS patients referred to our section from 1983 up until 1990, were treated three times with radiotherapy (29-50 kV, 2-4 Gy), once every second week. Initially, 74 skin KSs were treated three times with 2 Gy, of which 70% were treated successfully. Hereafter, other 2,066 KSs on the skin were treated three times with 4 Gy with a very high success rate of 93%. Additional 165 mucous KSs were treated three times with 4 Gy, of which 91% were treated successfully. Low-dose radiotherapy is effective for the treatment of many AIDS-related KS patients.

Image analysis of multiple organ invasion in patients with AIDS-related Kaposi's sarcoma

OBJECTIVE: This study was performed to analyze the clinical imaging manifestations of multiple organ and tissue invasion in patients with AIDS-related Kaposi's sarcoma (KS), improve the understanding of AIDS-related KS, and provide the basis for clinical diagnosis and treatment. MATERIALS AND METHODS: Relevant data of patients who had been diagnosed with AIDS-related KS at several infectious disease hospitals in China were collected. The clinical manifestations and imaging and pathological data of 48 patients were sorted and analyzed retrospectively. Among the 48 patients, 45 were male and 3 were female, and their age ranged from 19 to 71 years. RESULTS: Of the 48 patients with AIDS-related KS, 37 (77.1%) patients had a CD4+ cell count of &lt; 100 cells/μL. Thirty-eight of the 48 patients had lung invasion; among these 38 patients, 30 (78.9%) patients' images contained nodular shadows. Computed tomography (transverse pulmonary window and mediastinal window as well as coronal microcolor reconstruction) showed lung nodules of different sizes and vascular distributions; they were widely connected to pulmonary vessels, some were flame like/star like, and some showed the “fruit-hanging sign.” Seven patients with liver invasion showed nodules and intrahepatic bile duct dilatation, and three patients had esophageal, gastric, and intestinal invasion. One patient with thyroid invasion showed low-density nodules. One patient with rib invasion and one patient with maxillary invasion showed lytic destruction and surrounding soft tissue nodules. Two or more organs and tissue were involved in 44 patients. CONCLUSION: The main imaging manifestations in patients with AIDS-related KS with multiple organ invasion were pleomorphic and vascular nodules. AIDS-related KS was also accompanied by invasion of the lungs, liver, digestive tract, thyroid, ribs, and maxilla, and the imaging manifestations were mainly irregular nodules closely related to blood vessels.

Visceral involvement as initial manifestation of AIDS-related Kaposi's sarcoma.

Visceral involvement as initial manifestation of AIDS-related Kaposi's sarcoma.

Visceral involvement as initial manifestation of AIDS-related Kaposi's sarcoma.

Visceral involvement as initial manifestation of AIDS-related Kaposi's sarcoma.

Effect of innate and adaptive immune mechanisms on treatment regimens in an AIDS-related Kaposi's Sarcoma model

Kaposi Sarcoma (KS) is the most common AIDS-defining cancer, even as HIV-positive people live longer. Like other herpesviruses, human herpesvirus-8 (HHV-8) establishes a lifelong infection of the host that in association with HIV infection may develop at any time during the illness. With the increasing global incidence of KS, there is an urgent need of designing optimal therapeutic strategies for HHV-8-related infections. Here we formulate two models with innate and adaptive immune mechanisms, relevant for non-AIDS KS (NAKS) and AIDS-KS, where the initial condition of the second model is given by the equilibrium state of the first one. For the model with innate mechanism (MIM), we define an infectivity resistance threshold that will determine whether the primary HHV-8 infection of B-cells will progress to secondary infection of progenitor cells, a concept relevant for viral carriers in the asymptomatic phase. The optimal control strategy has been employed to obtain treatment efficacy in case of a combined antiretroviral therapy (cART). For the MIM we have shown that KS therapy alone is capable of reducing the HHV-8 load. In the model with adaptive mechanism (MAM), we show that if cART is administered at optimal levels, that is, 0.48 for protease inhibitors, 0.79 for reverse transcriptase inhibitors and 0.25 for KS therapy, both HIV-1 and HHV-8 can be reduced. The predictions of these mathematical models have the potential to offer more effective therapeutic interventions in the treatment of NAKS and AIDS-KS.

Rapid and Elevated Tumor Responses to Wekley Paclitaxel for AIDS-Related Kaposi Sarcoma

Kaposi sarcoma is a rare condition, it is an incurable disease with a poor prognosis, the treatment of this pathology is variable including surgery, Radiotherapy, chemotherapy and antiviral treatments. A number of drugs approved for the treatment of KS associated with AIDS, in particular the pegylated liposomal doxorubicin (DLP) which is currently the standard, Paclitaxel, have also shown efficacy against advanced SK. We report a case of a patient with kaposi's sarcoma associated with HIV metastatic in the lung, liver and lymph nodes and who presented an almost complete response after 4 months of chemotherapy with weekly Paclitaxel at a dose of 100 mg in our department of medical oncology at CHU Hassan II in Fez. Of interest is the complete response to paclitaxel treatment in a patient followed for metastatic kaposi sarcoma.

1640P Pegylated liposomal doxorubicin (PLD) as first line treatment in AIDS-related Kaposi’s sarcoma (AIDS-KS): A single institution retrospective study

1640P Pegylated liposomal doxorubicin (PLD) as first line treatment in AIDS-related Kaposi’s sarcoma (AIDS-KS): A single institution retrospective study