Rapid regression of Kaposi’s sarcoma of the hard palate under therapy with boosted elvitegravir-containing fixdose antiretroviral combination therapy
- 242 Downloads
Abstract
Introduction
Kaposi’s sarcoma (KS) is a rare vascular tumor that may occur in a severe, rapidly progressive form, namely in HIV/AIDS patients. HIV-associated KS mainly affects the skin and mucous membranes.
Case presentation
We report about an HIV-positive patient who presented with an exophytic growing tumor in the region of the hard palate and severe problems regarding his dental status. Histological examination revealed evidence of AIDS-related KS. Antiretroviral therapy initiation with elvitegravir/cobicistat/emtricitabine(FTC)/tenofovirdisoproxilfumarat (E/c/F/T-fix dose combination) resulted in rapid complete remission of the KS within 2 months.
Conclusion
In this case of a treatment-naive HIV-infected patient with coexisting KS, antiretroviral therapy with E/c/FTC/TDF was very well suited to achieve rapid complete remission of KS.
Keywords
Kaposi HIV ElvitegravirNotes
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
Approval by the ethics committee
An approval by an ethics committee was not applicable.
Informed consent
The patient gave informed consent to publication of his case.
References
- 1.Stiller CA, Trama A, Brewster DH, Verne J, Bouchardy C, Navarro C, et al. Descriptive epidemiology of Kaposi sarcoma in Europe. Report from the RARECARE project. Cancer Epidemiol. 2014;38:670–8.CrossRefPubMedGoogle Scholar
- 2.Franceschi S, Lise M, Clifford GM, et al. Changing patterns of cancer incidence in the early- and late-HAART periods: the Swiss HIV Cohort Study. Br J Cancer. 2010;103:416–22.PubMedCentralCrossRefPubMedGoogle Scholar
- 3.Grabar S, Abraham B, Mahamat A, Del Giudice P, Rosenthal E, Costagliola D. Differential impact of combination antiretroviral therapy in preventing Kaposi’s sarcoma with and without visceral involvement. JCO. 2006;24:3408–14.CrossRefGoogle Scholar
- 4.Simard EP, Pfeiffer RM, Engels EA. Cumulative incidence of cancer among individuals with acquired immunodeficiency syndrome in the United States. Cancer. 2011;117:1089–96.PubMedCentralCrossRefPubMedGoogle Scholar
- 5.Laney AS, Cannon MJ, Jaffe HW, et al. Human herpesvirus 8 presence and viral load are associated with the progression of AIDS-associated Kaposi’s sarcoma. AIDS. 2007;21:1541–5.CrossRefPubMedGoogle Scholar
- 6.Marshall V, Martró E, Labo N, et al. Kaposi sarcoma (KS)-associated herpesvirus microRNA sequence analysis and KS risk in a European AIDS-KS case control study. J Infect Dis. 2010;202:1126–35.PubMedCentralCrossRefPubMedGoogle Scholar
- 7.Pauk J, Huang ML, Brodie SJ, et al. Mucosal shedding of human herpesvirus 8 in men. N Engl J Med. 2000;343:1369–77.CrossRefPubMedGoogle Scholar
- 8.Pica F, Volpi A. Transmission of human herpesvirus 8: an update. Curr Opin Infect Dis. 2007;20:152–6.CrossRefPubMedGoogle Scholar
- 9.Di Bella S, Petrosillo N. Kaposi’s sarcoma symmetric mucosal lesions. Infection. 2013;41(1):297.CrossRefPubMedGoogle Scholar
- 10.Servato JP, Loyola AM, Spini PH, Spini TH, de Faria PR, Cardoso SV. Regression of oral Kaposi’s sarcoma antiretroviral therapy. Infection. 2013;41:1201–2.CrossRefPubMedGoogle Scholar
- 11.Bower M, Weir J, Francis N, et al. The effect of HAART in 254 consecutive patients with AIDS-related Kaposi’s sarcoma. AIDS. 2009;23:1701–6.CrossRefPubMedGoogle Scholar
- 12.Cattelan AM, Calabro ML, De Rossi A, et al. Long-term clinical outcome of AIDS-related Kaposi’s sarcoma during highly active antiretroviral therapy. Int J Oncol. 2005;27:779–85.PubMedGoogle Scholar
- 13.Bower M, Dalla Pria A, Coyle C, et al. Prospective stage-stratified approach to AIDS-related Kaposi’s sarcoma. J Clin Oncol. 2014;32:409–14.CrossRefPubMedGoogle Scholar
- 14.Sgadari C, Barillari G, Toschi E, et al. HIV protease inhibitors are potent anti-angiogenic molecules and promote regression of Kaposi sarcoma. Nat Med. 2002;8:225–32.CrossRefPubMedGoogle Scholar
- 15.Gantt S, Carlsson J, Ikoma M, et al. The HIV protease inhibitor nelfinavir inhibits Kaposi sarcoma-associated herpesvirus replication in vitro. Antimicrob Agents Chemother. 2011;55:2696–703 (Epub ahead of print).PubMedCentralCrossRefPubMedGoogle Scholar
- 16.Martinez V, Caumes E, Gambotti L, et al. Remission from Kaposi’s sarcoma on HAART is associated with suppression of HIV replication and is independent of protease inhibitor therapy. Br J Cancer. 2006;94:1000–6.PubMedCentralCrossRefPubMedGoogle Scholar
- 17.Gantt S, Cattamanchi A, Krantz E, et al. Reduced human herpesvirus-8 oropharyngeal shedding associated with protease inhibitor-based antiretroviral therapy. J Clin Virol. 2014;60:127–32.PubMedCentralCrossRefPubMedGoogle Scholar
- 18.Asiimwe F, Moore D, Were W, Nakityo R, Campbell J, Barasa A, et al. Clinical outcomes of HIV-infected patients with Kaposi’s sarcoma receiving nonnucleoside reverse transcriptase inhibitor-based antiretroviral therapy in Uganda. HIV Med. 2012;13(3):166–71.PubMedGoogle Scholar