Govindan Balaji
Department of STD, Government Mohan Kumaramangalam Medical College, Salem, Tamil Nadu, India.
Indian J Sex Transm Dis AIDS. 2016 Jul-Dec;37(2):115-122. doi: 10.4103/0253-7184.192120.
Acquired immuno deficiency syndrome (AIDS) associated Kaposi's sarcoma (KS) is one of the clinical forms of KS. KS is caused by human herpes viruses 8 or KS associated herpes virus (KSHV). In India, till now, only 16 cases of AIDS associated KS was reported. Of all the clinical forms of KS, AIDS associated KS is distinct in many ways viz.; cutaneous manifestations commonly affects face and trunk rather than lower limbs, more mucosal lesions, rapidly progressive, and early systemic involvement. When human immunodeficiency virus (HIV) is co-infected with KSHV, in addition to the other pathogenic factors for the development of KS, HIV Tat protein promotes the proliferation of cytokine-activated endothelial cells and stimulates KS. Moreover, actions of HIV Tat lead to the aggressive course of KS in patients with AIDS, compared with the more confined behavior of KS in HIV-negative persons. Similarly, latency-associated nuclear antigen of KSHV would enhance HIV replication by activating the long terminal repeats of HIV-1 through its association with Tat. Effective antiretroviral treatment in AIDS associated KS results in reduction of the incidence of AIDS-related KS and regression of the existing lesions. Early diagnosis and treatment of AIDS associated KS would definitely increase the life span and quality of the patients.
获得性免疫缺陷综合征（AIDS）相关的卡波西肉瘤（KS）是KS的临床形式之一。KS由人类疱疹病毒8型或KS相关疱疹病毒（KSHV）引起。在印度，截至目前，仅报告了16例AIDS相关的KS病例。在KS的所有临床形式中，AIDS相关的KS在许多方面都有所不同，即：皮肤表现通常影响面部和躯干而非下肢，黏膜病变更多，进展迅速，且早期有全身受累。当人类免疫缺陷病毒（HIV）与KSHV共同感染时，除了KS发生的其他致病因素外，HIV反式激活蛋白（Tat蛋白）会促进细胞因子激活的内皮细胞增殖并刺激KS。此外，与HIV阴性者中KS的局限性表现相比，HIV Tat蛋白的作用导致AIDS患者的KS病程更为凶险。同样，KSHV的潜伏相关核抗原通过与Tat蛋白结合激活HIV-1的长末端重复序列，从而增强HIV复制。对AIDS相关KS进行有效的抗逆转录病毒治疗可降低AIDS相关KS的发病率，并使现有病变消退。对AIDS相关KS进行早期诊断和治疗肯定会延长患者的寿命并提高其生活质量。
