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Kaposi's sarcoma progressing despite HAART
Jun 21, 2007

I got a kaposi's sarcoma on one on my toe almst a year ago and it was treated with radiotherapy and it went away. At that point i started taking Atripla. My Dr. says Atripla would stop developing more KS but i had new ones in my back and legs. The Dermatologist asked me to see an oncologist to star chemotherapy cuz i have KS spread on my body. Does chemo really help? Is KS that bad even if i'm taking Atripla for about 8 months? Can chemo drop my CD4?

Response from Dr. Pierone

Hello and thanks for posting.

In most cases, Kaposi's Sarcoma stops progressing and often recedes in response to HAART. However, this is not always the case. There are some instances in which KS progresses despite virologic control and immune reconstitution. If so, additional treatment such as KS-specific chemotherapy may be necessary. Part of the decision to initiate chemotherapy depends on the extent of the KS spread and the tempo the progression. There may be delayed immune reconstitution in some people which might explain why KS sometimes marches on despite antiretroviral therapy. If the lesions are indolent and slow growing it is possible that KS lesions may still come under control with more time on HAART. That said, it certainly makes sense to see an oncologist and discuss treatment options. Some types of chemotherapy do result in a CD4+ lymphocyte count drop, but it is usually temporary.

Also, it would be helpful to know what your viral load and CD4 counts were before and after initiation of Atripla. Let us know how things turn out and what you decide to do. Best of luck to you!

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