Jul 9, 2006
Hi, I'm a 42 yo HIV positive gay man since may 1987. Back in 1994, I developed 3 KS lessions on one foot. I started on AZT and the lessions were removed. I developed two more lessions a year later and since then - 1995 - everything went fine. After a long time with VL under 50 copies and having developed a light buffalo hump and some lipodistrophy on legs and butt, my doctor and I decided to go off meds two and a half years ago. Everything was fine till two months ago, when I saw two wierd lessions on my left foot. Went to see my doctor, have my lab test done ( VL 22.423 , CD4 391 and 23 % ) and he said that we could wait a bit more to go back on HAART. I went to see my dermatologist and, after a biopsy,KS was confirmed - 4 small lessions - and she's trying to find out what's the best to do: to just treat the individual lessions or to go back to the HIV meds... What's your suggestion ? I'm from Argentina and it's quite hard to find a KS especialist. Could KS remain like that ? I'm at risk of developing something else ?? Thanks for your answer !!! Paul
Response from Dr. Daar
Hi Paul, KS certainly can recur and can do so even when CD4 cells remain reasonably high. I think that it would be reasonable to restart antiretrovirals with follow-up of the lesions to see if they resolve or to treat the lesions locally with continued follow-up of your clinical situation and CD4 cells to guide you in deciding when to restart HIV medications. Both strategies have obvious advantages and disadvantages. Therefore, you should discuss this further with your providers and decide what is best for you.
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