dear doctor

i'm a (young) hiv+ guy from sydney, australia, for a year now. 3 months ago, i had a very low t-cell count and a high viral load. i started to get night sweats. my doctor had me started on medication to be on the safe side. i'm now taking a combination of lamivudine, nevirapine and didanosine. i feel 100 now, no more night sweats and i don't get tired easily anymore and i don't easily get sick or any kind of infection i.e flu/cold. my problem now is, a patchy like rash appeared on both my upper arms and my legs started to swell up. i went through several tests and had discovered that the marks i have on my arms were k.s. - kaposis sarcoma. i have been going back and forth to see my docotr regularly and he has advised me just to keep on taking my medication as the k.s. will slowly disappear or i have another option which is something like i have to go on a drip(chemotheraphy) once a week to speed up the disappearance of the k.s. but it will lower my t cell count. my doctor told me it came out because of sudden reaction of my body to the medication. the good news is my viral load now is undetectable. how long do you think it would take for it to really go away? everytime, i'd see my doctor, he thinks that it's fading away slowly, i really don't notice any difference. what should i do? any other alternative to get rid of the k.s.? thank you for listening.

Hello, my personal experience is that KS usually goes away as the immune system recovers and CD4 cells increase on antiretroviral therapy. In some cases it doesn't resolve, and chemotherapy for KS is necessary. The chemo is not fun and it is a judgment call whether to wait it out or proceed with chemotherapy. If there are objective signs of improvement (legs less swollen, no new lesions, lesions fading) then waiting is out is reasonable. Sometimes digital pictures will allow a more objective assessment of progress (or lack thereof). Good luck!