Department of Dermatology, Inserm U1058.
Herault Tumor Registry.
AIDS. 2021 Mar 1;35(3):399-405. doi: 10.1097/QAD.0000000000002744.
Kaposi sarcoma in people living with HIV (PLHIV) is the most common AIDS-associated malignancy. There is increased interest in Kaposi sarcoma in PLHIV with controlled HIV viremia.
To describe Kaposi sarcoma occurring in PLHIV despite virological control and to compare their clinical presentations with viremic AIDS-Kaposi sarcoma (AIDS-KS) and classic Kaposi sarcoma (CKS).
This was a monocentric retrospective study, including all Kaposi sarcoma patients registered between the 1 January of 2000 and 31 December 2017 in a comprehensive data bank for all cancers in the Hérault region, South of France. AIDS-KS were also described using chart reviews from the Infectious diseases Department, which followed more than 90% of PLHIV from the same region. We defined aviremic AIDS-KS as Kaposi sarcoma occurring in persons taking HAART with a HIV viral load less than 50 copies for more than 12 months. We compared clinical characteristics of persons with aviremic AIDS-KS, viremic AIDS-KS and CKS, using the Kriegel score and number and topography of skin lesions, and presence of lymphedema.
We retrieved 187 Kaposi sarcoma cases, of which 12 occurred in PLHIV with aviremic AIDS-KS. Kriegel score stage I was found in 10 (83%) of the aviremic AIDS-KS, 34 (68%) of CKS and 38 (58.4%) of viremic AIDS-KS cases, with similar clinical presentations between aviremic AIDS-KS and CKS groups, and viremic AIDS-KS persons having more aggressive presentations. One person with aviremic AIDS-KS had visceral involvement.
We showed that Kaposi sarcoma in PLHIV with controlled viremia were generally indolent, similarly to CKS. Visceral involvement is, however, possible.
人类免疫缺陷病毒(HIV)感染者中的卡波西肉瘤(KS)是最常见的艾滋病相关恶性肿瘤。对于 HIV 病毒载量得到控制的 HIV 感染者中的 KS,人们的兴趣日益增加。
描述 HIV 病毒载量得到控制的 HIV 感染者中出现的 KS,并将其临床表现与病毒血症性艾滋病相关 KS(AIDS-KS)和经典 KS(CKS)进行比较。
这是一项单中心回顾性研究,纳入了 2000 年 1 月 1 日至 2017 年 12 月 31 日期间在法国南部埃罗省癌症综合数据库中登记的所有 KS 患者。通过对同一地区的 90%以上 PLHIV 进行随访的传染病科病历回顾,还描述了 AIDS-KS。我们将接受高效抗逆转录病毒治疗(HAART)且 HIV 病毒载量小于 50 拷贝并持续 12 个月以上的患者中的 KS 定义为无病毒血症性 AIDS-KS。我们使用 Kriegel 评分以及皮肤损伤的数量和位置、淋巴水肿的存在,比较了无病毒血症性 AIDS-KS、病毒血症性 AIDS-KS 和 CKS 患者的临床特征。
我们共检索到 187 例 KS 病例,其中 12 例发生在无病毒血症性 AIDS-KS 的 PLHIV 中。无病毒血症性 AIDS-KS 患者的 Kriegel 评分Ⅰ期为 10 例(83%),CKS 为 34 例(68%),病毒血症性 AIDS-KS 为 38 例(58.4%),无病毒血症性 AIDS-KS 和 CKS 组的临床表现相似,病毒血症性 AIDS-KS 患者的临床表现更为侵袭性。1 例无病毒血症性 AIDS-KS 患者有内脏受累。
我们发现,HIV 病毒载量得到控制的 PLHIV 中的 KS 通常呈惰性,与 CKS 相似。然而,可能存在内脏受累。