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Remission from Kaposi's sarcoma on HAART is associated with suppression of HIV replication and is independent of protease inhibitor therapy
Highly active antiretroviral therapy (HAART) reduces the incidence and improves the prognosis of Kaposi's sarcoma (KS). This study was designed to identify factors associated with KS clinical responses in HIV-infected patients during HAART. We reviewed the files of 138 HIV-1-infected patients w...
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| Published in: | British journal of cancer 2006-04, Vol.94 (7), p.1000-1006 |
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| container_end_page | 1006 |
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| container_title | British journal of cancer |
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| creator | MARTINEZ, V CAUMES, E GAMBOTTI, L ITTAH, H MORINI, J.-P DELEUZE, J GORIN, I KATLAMA, C BRICAIRE, F DUPIN, N |
| description | Highly active antiretroviral therapy (HAART) reduces the incidence and improves the prognosis of Kaposi's sarcoma (KS). This study was designed to identify factors associated with KS clinical responses in HIV-infected patients during HAART. We reviewed the files of 138 HIV-1-infected patients with KS. Epidemiologic and HIV-related clinical and biological parameters were recorded at KS diagnosis (baseline) and every 6 months thereafter. In a subset of 73 antiretroviral-naive patients, we compared the clinical outcome of KS according to the use or nonuse of protease inhibitors (PI). After 6 months of follow-up, KS remission was more frequent in patients who were naive of HAART and who were at ACTG stage S0 at baseline (P = 0.03 and 0.02). Undetectable HIV viral load was strongly associated with KS remission (P< or = 0.004 at all time points), while CD4 cell count was not. Among the 73 antiretroviral-naive patients at baseline, and who were studied for 24 months, KS outcome did not differ between patients who were prescribed PI-containing and PI-sparing regimens. Intercurrent multicentric Castleman's disease was associated with poor outcome after 60 months of follow-up (P< or = 0.0001). Fourteen deaths occurred after a median follow-up of 37.5 months, eight of which were KS related. Suppression of HIV replication appears to be crucial to control KS. Non-PI-based regimens were equivalent to PI-based regimens as regards the clinical and virological outcome of antiretroviral-naive HIV-infected patients with KS. |
| doi_str_mv | 10.1038/sj.bjc.6603056 |
| format | article |
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This study was designed to identify factors associated with KS clinical responses in HIV-infected patients during HAART. We reviewed the files of 138 HIV-1-infected patients with KS. Epidemiologic and HIV-related clinical and biological parameters were recorded at KS diagnosis (baseline) and every 6 months thereafter. In a subset of 73 antiretroviral-naive patients, we compared the clinical outcome of KS according to the use or nonuse of protease inhibitors (PI). After 6 months of follow-up, KS remission was more frequent in patients who were naive of HAART and who were at ACTG stage S0 at baseline (P = 0.03 and 0.02). Undetectable HIV viral load was strongly associated with KS remission (P< or = 0.004 at all time points), while CD4 cell count was not. Among the 73 antiretroviral-naive patients at baseline, and who were studied for 24 months, KS outcome did not differ between patients who were prescribed PI-containing and PI-sparing regimens. Intercurrent multicentric Castleman's disease was associated with poor outcome after 60 months of follow-up (P< or = 0.0001). Fourteen deaths occurred after a median follow-up of 37.5 months, eight of which were KS related. Suppression of HIV replication appears to be crucial to control KS. Non-PI-based regimens were equivalent to PI-based regimens as regards the clinical and virological outcome of antiretroviral-naive HIV-infected patients with KS.</description><identifier>ISSN: 0007-0920</identifier><identifier>EISSN: 1532-1827</identifier><identifier>DOI: 10.1038/sj.bjc.6603056</identifier><identifier>PMID: 16570046</identifier><identifier>CODEN: BJCAAI</identifier><language>eng</language><publisher>Basingstoke: Nature Publishing Group</publisher><subject>Acquired immune deficiency syndrome ; Adult ; Aged ; AIDS ; Antiretroviral Therapy, Highly Active ; Biological and medical sciences ; Cancer research ; Cancer therapies ; CD4 Lymphocyte Count ; Clinical Study ; Dermatology ; Drug therapy ; Female ; HIV ; HIV Infections - complications ; HIV Infections - drug therapy ; Human immunodeficiency virus ; Humans ; Kaposis sarcoma ; Male ; Medical prognosis ; Medical research ; Medical sciences ; Middle Aged ; Neoplasm Staging ; Prognosis ; Protease Inhibitors - pharmacology ; Protease Inhibitors - therapeutic use ; Remission (Medicine) ; Retrospective Studies ; Sarcoma, Kaposi - drug therapy ; Sarcoma, Kaposi - virology ; Survival Analysis ; Treatment Outcome ; Tumors ; Tumors of the skin and soft tissue. Premalignant lesions ; Viral Load ; Virus Replication - drug effects</subject><ispartof>British journal of cancer, 2006-04, Vol.94 (7), p.1000-1006</ispartof><rights>2006 INIST-CNRS</rights><rights>Copyright Nature Publishing Group Apr 10, 2006</rights><rights>Copyright © 2006 Cancer Research UK 2006 Cancer Research UK</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c498t-2c42847de4fe0474f3dd8f3403e1a1a56388534668a2b266f325ac1e531e9cbc3</citedby><cites>FETCH-LOGICAL-c498t-2c42847de4fe0474f3dd8f3403e1a1a56388534668a2b266f325ac1e531e9cbc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2361239/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2361239/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,733,786,790,891,27957,27958,53827,53829</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17708793$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16570046$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>MARTINEZ, V</creatorcontrib><creatorcontrib>CAUMES, E</creatorcontrib><creatorcontrib>GAMBOTTI, L</creatorcontrib><creatorcontrib>ITTAH, H</creatorcontrib><creatorcontrib>MORINI, J.-P</creatorcontrib><creatorcontrib>DELEUZE, J</creatorcontrib><creatorcontrib>GORIN, I</creatorcontrib><creatorcontrib>KATLAMA, C</creatorcontrib><creatorcontrib>BRICAIRE, F</creatorcontrib><creatorcontrib>DUPIN, N</creatorcontrib><title>Remission from Kaposi's sarcoma on HAART is associated with suppression of HIV replication and is independent of protease inhibitor therapy</title><title>British journal of cancer</title><addtitle>Br J Cancer</addtitle><description>Highly active antiretroviral therapy (HAART) reduces the incidence and improves the prognosis of Kaposi's sarcoma (KS). This study was designed to identify factors associated with KS clinical responses in HIV-infected patients during HAART. We reviewed the files of 138 HIV-1-infected patients with KS. Epidemiologic and HIV-related clinical and biological parameters were recorded at KS diagnosis (baseline) and every 6 months thereafter. In a subset of 73 antiretroviral-naive patients, we compared the clinical outcome of KS according to the use or nonuse of protease inhibitors (PI). After 6 months of follow-up, KS remission was more frequent in patients who were naive of HAART and who were at ACTG stage S0 at baseline (P = 0.03 and 0.02). Undetectable HIV viral load was strongly associated with KS remission (P< or = 0.004 at all time points), while CD4 cell count was not. Among the 73 antiretroviral-naive patients at baseline, and who were studied for 24 months, KS outcome did not differ between patients who were prescribed PI-containing and PI-sparing regimens. Intercurrent multicentric Castleman's disease was associated with poor outcome after 60 months of follow-up (P< or = 0.0001). Fourteen deaths occurred after a median follow-up of 37.5 months, eight of which were KS related. Suppression of HIV replication appears to be crucial to control KS. Non-PI-based regimens were equivalent to PI-based regimens as regards the clinical and virological outcome of antiretroviral-naive HIV-infected patients with KS.</description><subject>Acquired immune deficiency syndrome</subject><subject>Adult</subject><subject>Aged</subject><subject>AIDS</subject><subject>Antiretroviral Therapy, Highly Active</subject><subject>Biological and medical sciences</subject><subject>Cancer research</subject><subject>Cancer therapies</subject><subject>CD4 Lymphocyte Count</subject><subject>Clinical Study</subject><subject>Dermatology</subject><subject>Drug therapy</subject><subject>Female</subject><subject>HIV</subject><subject>HIV Infections - complications</subject><subject>HIV Infections - drug therapy</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Kaposis sarcoma</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Prognosis</subject><subject>Protease Inhibitors - pharmacology</subject><subject>Protease Inhibitors - therapeutic use</subject><subject>Remission (Medicine)</subject><subject>Retrospective Studies</subject><subject>Sarcoma, Kaposi - drug therapy</subject><subject>Sarcoma, Kaposi - virology</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Tumors of the skin and soft tissue. 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This study was designed to identify factors associated with KS clinical responses in HIV-infected patients during HAART. We reviewed the files of 138 HIV-1-infected patients with KS. Epidemiologic and HIV-related clinical and biological parameters were recorded at KS diagnosis (baseline) and every 6 months thereafter. In a subset of 73 antiretroviral-naive patients, we compared the clinical outcome of KS according to the use or nonuse of protease inhibitors (PI). After 6 months of follow-up, KS remission was more frequent in patients who were naive of HAART and who were at ACTG stage S0 at baseline (P = 0.03 and 0.02). Undetectable HIV viral load was strongly associated with KS remission (P< or = 0.004 at all time points), while CD4 cell count was not. Among the 73 antiretroviral-naive patients at baseline, and who were studied for 24 months, KS outcome did not differ between patients who were prescribed PI-containing and PI-sparing regimens. Intercurrent multicentric Castleman's disease was associated with poor outcome after 60 months of follow-up (P< or = 0.0001). Fourteen deaths occurred after a median follow-up of 37.5 months, eight of which were KS related. Suppression of HIV replication appears to be crucial to control KS. Non-PI-based regimens were equivalent to PI-based regimens as regards the clinical and virological outcome of antiretroviral-naive HIV-infected patients with KS.</abstract><cop>Basingstoke</cop><pub>Nature Publishing Group</pub><pmid>16570046</pmid><doi>10.1038/sj.bjc.6603056</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | British journal of cancer, 2006-04, Vol.94 (7), p.1000-1006 |
| issn | 0007-0920 1532-1827 |
| language | eng |
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| source | PubMed Central |
| subjects | Acquired immune deficiency syndrome Adult Aged AIDS Antiretroviral Therapy, Highly Active Biological and medical sciences Cancer research Cancer therapies CD4 Lymphocyte Count Clinical Study Dermatology Drug therapy Female HIV HIV Infections - complications HIV Infections - drug therapy Human immunodeficiency virus Humans Kaposis sarcoma Male Medical prognosis Medical research Medical sciences Middle Aged Neoplasm Staging Prognosis Protease Inhibitors - pharmacology Protease Inhibitors - therapeutic use Remission (Medicine) Retrospective Studies Sarcoma, Kaposi - drug therapy Sarcoma, Kaposi - virology Survival Analysis Treatment Outcome Tumors Tumors of the skin and soft tissue. Premalignant lesions Viral Load Virus Replication - drug effects |
| title | Remission from Kaposi's sarcoma on HAART is associated with suppression of HIV replication and is independent of protease inhibitor therapy |
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