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Colafigli M, Ciccullo A, Borghetti A, Fanti I, Melis F, Modica S, Uccella I, Bonadies A, Ferraresi V, Anzalone E, Pennica A, Migliano E, Rossetti B, Madeddu G, Cauda R, Cristaudo A, Di Giambenedetto S, Latini A. Impact of Antiretroviral Therapy on the Risk of Recurrence in HIV-1 Infected Patients with Kaposi Sarcoma: A Multicenter Cohort Experience. J Clin Med 2019; 8:jcm8122062. [PMID: 31771172 PMCID: PMC6947508 DOI: 10.3390/jcm8122062] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 11/19/2019] [Accepted: 11/21/2019] [Indexed: 12/17/2022] Open
Abstract
Kaposi sarcoma (KS) remains a relevant malignancy in human immunodeficiency virus (HIV)-infected patients with a non-standardized management; despite past suggestions that ritonavir-boosted protease inhibitor (bPI)-based regimens could be preferable, no combination antiretroviral therapy (cART) regimen was demonstrated to outperform the others and the impact of new drugs, drug classes or paradigms was never investigated nor proven better than previous therapeutic regimes. In order to do this, we retrospectively collected data regarding HIV-infected patients with a diagnosis of KS last seen in six Italian centers after 1 January 2013. A total of 104 KS cases in 99 patients was analyzed for 945.34 patient-year follow-up (PYFU). Twenty-six patients had visceral localizations. Thirty-three patients were treated with chemotherapy, four with electrochemotherapy, and 12 with α-interferon (α-IFN). At censor, 22% received a bPI-based, 14% a non-nucleoside reverse transcriptase inhibitor (NNRTI)-based, and 28% an integrase inhibitor (INI)-based standard cART, 24% a less drug regimen and 12% a mega-cART. Twelve recurrence episodes were observed in seven patients for an incidence of 1.27 per 100 PYFU. Two patients with no evidence of recurrence episodes died for other reasons. In our experience, KS recurrence episodes were infrequent. Despite the increasing use of new antiretroviral drug classes and new treatment paradigms, no excess of recurrence episodes was observed in patients receiving such cART regimens.
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Affiliation(s)
- Manuela Colafigli
- Infectious Dermatology and Allergology, San Gallicano Dermatological Institute IRCCS, 00144 Rome, Italy
- Correspondence ; Tel.: +39-0652662808
| | - Arturo Ciccullo
- Clinical Infectious Diseases, Catholic University of S. Heart, 00168 Rome, Italy
| | - Alberto Borghetti
- Clinical Infectious Diseases, Catholic University of S. Heart, 00168 Rome, Italy
| | - Iuri Fanti
- Clinical Infectious Diseases, Catholic University of S. Heart, 00168 Rome, Italy
| | - Federico Melis
- Unit of Infectious Diseases, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari Italy
| | - Sara Modica
- Department of Medical Biotechnologies, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy
- Infectious Diseases Unit, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy
| | | | - Antonio Bonadies
- Plastic Surgery, San Gallicano Dermatological Institute IRCCS, 00144 Rome, Italy
| | - Virginia Ferraresi
- First Division of Medical Oncology, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | | | | | - Emilia Migliano
- Plastic Surgery, San Gallicano Dermatological Institute IRCCS, 00144 Rome, Italy
| | - Barbara Rossetti
- Infectious Diseases Unit, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy
| | - Giordano Madeddu
- Unit of Infectious Diseases, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari Italy
| | - Roberto Cauda
- Clinical Infectious Diseases, Catholic University of S. Heart, 00168 Rome, Italy
| | - Antonio Cristaudo
- Infectious Dermatology and Allergology, San Gallicano Dermatological Institute IRCCS, 00144 Rome, Italy
| | | | - Alessandra Latini
- Infectious Dermatology and Allergology, San Gallicano Dermatological Institute IRCCS, 00144 Rome, Italy
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Franco JB, Maureira Pena LJ, Martins E Martins F, de Oliveira MA, Ortega KL. Regression of human immunodeficiency virus-associated oral Kaposi sarcoma with combined antiretroviral therapy: A case report and literature review. Head Neck 2018; 41:E21-E25. [PMID: 30552825 DOI: 10.1002/hed.25446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 08/15/2018] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Kaposi's sarcoma (KS) is the most prevalent malignant neoplasia in human immunodeficiency virus positive (HIV+) patients for which the primary mode of management was chemotherapy. METHODS We have presented the case of a newly diagnosed HIV+ male patient who was diagnosed with a pedunculated nodule in the anterior region of the hard palate, measuring 3.5 cm in diameter and with 2 months of evolution. RESULTS Histopathological examination confirmed the clinical hypothesis of KS. Soon after the diagnosis, the patient started using combined antiretroviral therapy (Biovir and Kaletra), presenting a significant reduction of the lesion after 4 weeks. With 1.5 cm in diameter, the lesion was surgically removed. The patient was followed-up for 10 years without any recurrence. CONCLUSION In antiretroviral-naive patients with a well-preserved immune system, the use of cART may be efficient in reducing the progression of the KS lesions, thus avoiding the use of chemotherapeutic agents.
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Affiliation(s)
- Juliana Bertoldi Franco
- Oral Pathology, Department of Stomatology, University of Sao Paulo School of Dentistry, Sao Paulo, Brazil.,Division of Dentistry, Hospital of Clinics of the University of São Paulo School of Medicine, São Paulo, Brazil
| | - Loreto José Maureira Pena
- Special Care Dentistry Centre, Department of Stomatology, University of Sao Paulo School of Dentistry, Sao Paulo, Brazil
| | - Fabiana Martins E Martins
- Special Care Dentistry Centre, Department of Stomatology, University of Sao Paulo School of Dentistry, Sao Paulo, Brazil.,School of Dentistry, Santo Amaro University, São Paulo, Brazil
| | - Marcio Augusto de Oliveira
- Special Care Dentistry Centre, Department of Stomatology, University of Sao Paulo School of Dentistry, Sao Paulo, Brazil
| | - Karem L Ortega
- Oral Pathology, Department of Stomatology, University of Sao Paulo School of Dentistry, Sao Paulo, Brazil.,Special Care Dentistry Centre, Department of Stomatology, University of Sao Paulo School of Dentistry, Sao Paulo, Brazil
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