I was diagnosed 7 weeks ago that I am HIV positive and that the small purple spots on my neck was KS. At that time my CD4 cell count was 143 and Viral load 438,080. After 5 weeks on medication my CD4 cell count went to 350 and my Viral load to 1300. My doctor told me that once my immune system improves that the KS may go away. Unfortunately, that does not seem to be the case. The spots seem to keep appearing (leg, arm)while the ones on my chest I've noticed have started to dry up. Therefore, I am alarmed in seeing more appear and am considering chemo. Could you please tell me (how/or/if) the chemo may help, how it is administered and if there are any side effects as well as how long chemo therapy takes? Thanks for any help you can give.

Your situation is actually not that uncommon. Both you are your physician are correct. Your immune system will improve, but this takes time. The improvement in your immune system will happen over the course of the next few months and continue over the next few years. In the mean time, it is NOT unusual for the initial KS lesions to grow. If a patient has a few small lesions, then I typically do not treat with chemotherapy, but rather let the immune system take over. HOWEVER, if a patient has a substantial number of lesions or large lesions, then I usually give him/her four to six cycles of chemotherapy. Typically I use Doxil, which is very well tolerated (doesn't usually cause hair loss and it goes well with your HIV drugs). In this way, both your HIV and KS will be treated. If you treat them both, you are more likely to have the KS lesions resolve nearly completely. I have treated many, many patients in this fashion. If you do indeed receive chemotherapy, the only HIV drug which does not mix well with chemotherapy is AZT (found in retrovir, combivir, and trizivir). If you were to be on one of these drugs, your HIV doctor might want to find an alternate HIV regimen. Good luck. You should do well.