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A Retrospective Analysis of AIDS-Associated Kaposi’s Sarcoma in Patients With Undetectable HIV Viral Loads and CD4 Counts Greater Than 300 cells/mm3

Division of Internal Medicine, Spokane Medical Centers, Spokane, Washington

Nancy Neil, PhD

School of Public Health, University of Washington, Seattle, Washington

Rebecca Israel, BA

Division of Hematology and Oncology, Virginia Mason Medical Center. Seattle, Washington

David M. Aboulafia, MD

Division of Hematology and Oncology, Virginia Mason Medical Center. Seattle, Washington, hemdma{at}vmmc.org

Objective: To compare the clinical course of patients with AIDS-related Kaposi’s sarcoma (KS) with CD4 counts >300 cells/mm³ and undetectable HIV viral loads (VLs) to patients with AIDS-KS with lesser CD4 counts and detectable HIV VLs.

Methods: We retrospectively analyzed a cohort of 91 patients with AIDS-KS in a multispeciality clinic. We used ² and Student t tests to analyze intragroup differences; survival was determined by Kaplan-Meier analysis.

Results: Twenty (22%) of the 91 patients had newly diagnosed, persistent or progressive KS despite CD4 counts >300 cells/mm³ and undetectable HIV VLs. Age, gender, ethnicity, mode and duration of HIV acquisition, type of antiretroviral therapy (ART), and KS therapy did not differ significantly (P .005) between this group and the remaining 71 patients. Although tumor stage and response to KS therapy were similar, there was a significantly greater risk of death among the patients with CD4 counts <300 cells/mm³ and detectable HIV VLs (P = .048).

Conclusions: In the highly active antiretroviral (HAART) era, a substantial proportion of patients with KS had undetectable HIV VLs and CD4 counts greater than the level typically associated with opportunistic diseases. They required systemic therapy to control their KS but were significantly less likely to die and demonstrated a trend toward better 15-year survival than patients having KS with lesser CD4 counts and detectable HIV VLs.

Key Words: Kaposi’s sarcoma • HIV • undetectable HIV viral loads • CD4 counts >cells/mm3

This version was published on September 1, 2009

Journal of the International Association of Physicians in AIDS Care (JIAPAC), Vol. 8, No. 5, 279-285 (2009)
DOI: 10.1177/1545109709341852


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