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When (at what CD4 count) can KS Lesions develop?
May 2, 2001

Just trying to clear up some confusion as it seems that there is different information on this matter everywhere I look. When can KS Lesions generally begin to develop after infection with HIV? I've heard that KS is an opportunistic infection that comes into play during late stages of HIV/AIDS and isn't usually a symptom of recent HIV infection or exposure. The CDC says KS lesions on the average don't show up for 8-11 years after HIV seroconversion, if at all. Is this true in your opinion? Thanks for your help.

Response from Dr. Dezube

You ask a good question regarding the timing of KS. Certain opportunistic infections such as pneumocystis pneumonia (PCP) and CMV retinitis don't occur until the CD4 count falls. In the case of PCP, most patients have CD4 < 200; in the case of CMV retinitis most have CD4 < 50. KS is quite different. Although it is more common in patients with lower CD4 counts than those with higher CD4 counts, KS can appear AT ANY CD4 count. Typically it is more aggressive as the CD4 count falls. HOWEVER, I have many patients in my practice whose disease has not read the book-- I have patients with CD4 counts greater than 500 with very aggressive KS, and patients with no CD4 counts with very mild KS. It would be unusual to see KS at the time of seroconversion,


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