Antiretroviral therapy with HIV-protease inhibitors in the treatment of AIDS-related Kaposi's sarcoma

Objectives. To evaluate the clinical response of AIDS-related Kaposi's sarcoma (KS) to a triple combination antiretroviral therapy including a protease inhibitor (HAART) and to determine the relationship between clinical outcome and HIV-1 viral burden and CD4+ cell count. Methods. Between October 1996 and October 1998 fourteen consecutive HIV+ patients with stable or progressive KS were enrolled. At study entry and subsequently every month, the patients underwent a complete clinical examination and their CD4+ cell counts and plasma HIV-1 RNA levels were determinated. The study treatment consisted of an antiretroviral therapy with a protease inhibitor and two nucleoside reverse transcriptase inhibitors. Results. The median follow-up time was 22.5 months. 10 complete and 2 partial clinical responses were achieved in a median time of 7 and 4 months, respectively. Two case of disease progression were observed. All patients with complete and partial remission showed a consistent decrease of HIV-RNA levels, paralleled by an increase of CD4+ cell counts. HIV-RNA level remained persistently high in two progressors. Conclusions. These findings suggest that antiretroviral therapy with a protease inhibitor is effective for AIDS-related KS. The clinical response correlates with a decrease in HIV load and an increase of lymphocytes CD4+ count.