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KS with good stats
Dec 28, 1999

I'm really confused and not getting alot of answers hopefully you can help. I've been HIV+ since 1984 my CD4 counts have always been above 500. I'm now dealing with my second occurrance of KS. The first one was about 5 years ago and I had no info on viral load. This time, my CD4 is 625 CD4% is 37 and viral load is undetectable <400. I thought my risk was rather low with these numbers. Also, each time I've had two separate lesions. Each one looked vastly different. One looks like a slightly round pea sized dot with a purple corona around it and the other looks like a purple pencil eraser that is raised above the skin. The second type also bleeds profusely when they remove part of it to send to pathology whereas the first type barely does at all. Also, I had the lesions treated with a lasor the first go around which was painful for a short period but left no scar and it never came back and there is no evidence that it was ever there now. The ones this time were frozen which seems more painful long term and has scarred. I've seen the pathology report both times and in fact they have been diagnosed as KS both times. What do you think of the lasor option as treatment, and why on earth is KS popping up on someone with good counts?

Response from Dr. Feinberg

Ks can occur even at high T cell counts, although it is more common and more serious in people with low counts. Even though your viral load is "undetectable", it isn't zero, and some individuals may be more susceptible to things like KS even at low viral loads. KS has a number od different appearances, and the fact that your two episodes looked different is not surprising. Since I'm not a dermatologist, I can't really comment on which technique is better-- in part, it may depend on the physician's preference.

kaposi and other skin problems
KS active despite O.K. T4 count

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