A prospective cohort study identifies two types of HIV+ Kaposi Sarcoma lesions: proliferative and inflammatory.
Razia MooradEdwards KasonkanjiJoe GumuliraYolanda GondweMorgan DeweyYue PanAlice PengLinda J PlutaEvaristar KudowaRichard NyasoselaTamiwe TomokaHannock TweyaTom HellerSalem GugsaSam PhiriDominic T MooreBlossom DamaniaMatthew PainschabMina C HosseinipourDirk P DittmerPublished in: International journal of cancer (2023)
Kaposi sarcoma (KS) is the most common cancer in people living with HIV (PLWH) in many countries where KS-associated herpesvirus is endemic. Treatment has changed little in 20 years, but the disease presentation has. This prospective cohort study enrolled 122 human immunodeficiency virus (HIV) positive KS patients between 2017 and 2019 in Malawi. Participants were treated with bleomycin, vincristine and combination antiretroviral therapy, the local standard of care. One-year overall survival was 61%, and progression-free survival was 58%. The 48-week complete response rate was 35%. RNAseq (n = 78) differentiated two types of KS lesions, those with marked endothelial characteristics and those enriched in inflammatory transcripts. This suggests that different KS lesions are in different disease states consistent with the known heterogeneous clinical response to treatment. In contrast to earlier cohorts, the plasma HIV viral load of KS patients in our study was highly variable. A total of 25% of participants had no detectable HIV; all had detectable KSHV viral load. Our study affirms that many KS cases today develop in PLWH with well-controlled HIV infection and that different KS lesions have differing molecular compositions. Further studies are needed to develop predictive biomarkers for this disease.
Keyphrases
- antiretroviral therapy
- hiv positive
- human immunodeficiency virus
- hiv infected
- hiv infected patients
- hiv aids
- men who have sex with men
- hepatitis c virus
- free survival
- newly diagnosed
- end stage renal disease
- ejection fraction
- south africa
- healthcare
- randomized controlled trial
- hiv testing
- oxidative stress
- magnetic resonance
- palliative care
- magnetic resonance imaging
- young adults
- squamous cell carcinoma
- patient reported outcomes
- prognostic factors
- clinical trial