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Kaposi sarcoma,tretmant Posted: Aug 10, 2006 QUESTION: I am with not huge expiriance instead of my 25 years work in infectiou diseases.One of my patients- 45 year-old women is dicovert last year and soon after that she is on HAART-Zerit 0,03, Videx 0,250 and Viracept. For one month she is with high temperature,diarea and red-brown lesions on the skin-most of them on distal legs and arms.I theng obout Kaposi sarcoma instead of HAART.my question is is that right dessision and what is the treatment uptodate?


RESPONSE FROM: Doctor- Thanks for your post. For Kaposi's sacroma that's limited to the skin (no visceral involvement), treatment with HAART is often sufficient to effect "cure"-- to this extent your right on track. The combination of d4T (Zerit), ddI (Videx) and nelfinavir (Nelfinavir) would not be one of my recommendations for a variety of reasons. First, d4T is no longer either preferred or alternate on DHHS guidelines; further the combo of d4T and ddI, once very popular, is not recommended because of increased risk of drug-related adverse reactions (pancreatitis, peripheral neuropathy and lactic acidosis). Nelfinavir (also once very popular for first-line treatment) has fallen from favor because of side effect profile (diarrhea) and the inability to boost the medication (with ritonavir). Current DHHS treatment guidelines give good guideance for contemporary "preferred" and "alternate" options. Most new regimens are dosed once-daily, using fixed-dose combination nucleosides with either efavirenz (Susitva, Stocrin) or a boosted protease inhibitor (lopinavir/ritonavir, atazanavir/ritonavir or fosamprenavir/ritonavir). I hope this is a useful starting point. Feel free to write me back here with any follow up questions. BY

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