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Treatment-naive patient needs initial regimen to fight KS

May 30, 2004

I am a white male, 43, positive for 6 years and never been on HIV meds. My viral load recently shot up to 185,000 (it had been around 20-40,000 for a couple of years), although my CD4s remain stable around 425 (unchanged for a couple of years). A recent biopsy confirmed KS and I now need to start on HIV meds.

Are there particular drugs (or drug classes) that you would recommend for treatment-naive patients who are diagnosed with KS?

How long might you expect it to take for the initial regimen to stop further KS lesions and also how long before meds might help the existing KS lesions to fade or disappear?

None of the lesions look really bad at this point (none on my face), and I do not have reason to suspect the KS has spread to the lungs or GI tract. If I do decide to treat the lesions (in addition to HIV meds), what treatments are currently recommended--chemo, radiation, freezing, alpha-interferon, etc...?

Thanks for your help and the great work that all of you do.

Response from Dr. Young

Thanks for your question.

You're correct in that treatment for HIV is indicated with your diagnosis of Kaposi's sarcoma (KS). There are some data that suggest that using a protease inhibitor-based regimen might be more effective against KS, but clinically speaking, I'd want to find the best regimen for you to take on this basis, but also on the basis of what treatment options are the best for your ability to take the medications on the long run.

While sometimes KS can flair immediately after starting HIV medications, I wouldn't expect to see new lesions after a couple of months, and typically the existing lesions begin to recede within 2-4 months too.

Hope this helps; good luck and let us know how things turn out. BY

Viral loads down and cell count down equals what?

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