all hope has been lost for a dear friend. 39 years old with Kaposi's sarcoma in one lung. CD4 cell count is only 4. Viral load is 550. Just sent home from hospital for pallative chemo, DR i known this is difficult question but is there any hope at all for my friend? oncologist refuse to do chemo because liver is not where they would like it be (condition). MIKE

I'm so sorry to hear this all. Although there are many good chemotherapy drugs for Kaposi's sarcoma, sometime patients do use up all there options. This may have indeed happened in your friend's case. Most chemotherapy is metabolized by the liver. So indeed it's a bad combination to have cancer which requires chemotherapy at the same time as having a liver which won't metabolize the chemotherapy. A lot depends on just how bad his liver is. We look at the bilirubin number. If it's over 3 (and particularly if it's greater than 5), then most likely he has some jaundice and it's hard to give the chemotherapy. A lot also depends upon how much your friend wants to pursue further treatment. If his CD4 count is just 4, I imagine that he's been on the HIV road for quite a well, having been on multiple HIV regimens.