scholarly journals Skin Lesions and Lower Extremity Edema in a newly diagnosed HIV patient

1970 ◽  
Vol 1 (1) ◽  
pp. 12-15
Author(s):  
Andrew B Trotter ◽  
Debra D Poutsiaka
Keyword(s):  
Differential Diagnosis ◽  
Lower Extremity ◽  
Highly Active Antiretroviral Therapy ◽  
Kaposi Sarcoma ◽  
Pulmonary Involvement ◽  
The United States ◽  
Skin Lesions ◽  
Newly Diagnosed ◽  
Mortality And Morbidity ◽  
Highly Active

The differential diagnosis of skin lesions in human immunodeficiency virus patients is diverse and includes both infectious and non infectious causes. In this case presentation, a 37 year old male newly diagnosed with HIV presented to a hospital in the United States with skin lesions and worsening lower extremity swelling. After presentation, he developed respiratory distress and was found to have disseminated Kaposi sarcoma with cutaneous and pulmonary involvement. Kaposi sarcoma has decreased in incidence in the era of highly active antiretroviral therapy. However, it remains an important acquired immunodeficiency syndrome defining illness which may be the presenting complaint in a patient with occult HIV infection. Kaposi sarcoma has substantial mortality and morbidity and should be included in the differential diagnosis of skin lesions in a HIV positive patient. DOI: http://dx.doi.org/10.3126/jaim.v1i1.5833 Journal of Advances in Internal Medicine. 2012; 1(1): 12-15

scholarly journals Coexistence of Kaposi sarcoma and Molluscum contagiosum on the same site in a HIV-AIDS patient: A very rare occurrence

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Kabir Abdullahi ◽  
Yahaya Mohammed ◽  
Saddiku A. Sahabi ◽  
Mahmood M. Dalhat
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
Kaposi Sarcoma ◽  
Skin Lesions ◽  
Molluscum Contagiosum ◽  
University Teaching ◽  
Therapy Regimen ◽  
Highly Active ◽  
Hiv Aids

Introduction: There have been numerous reported opportunistic infections among HIV/AIDS patients. However, coexistence of Kaposi sarcoma and Molluscum contagiosum on the same site is a rare finding.Case presentation: A 37-year-old man poorly adherent to antiretroviral therapy presented with Molluscum contagiosum and Kaposi sarcoma occurring simultaneously on numerous skin lesions around mid-2017 at Usmanu Danfodiyo University Teaching Hospital, Sokoto State, Nigeria.Management and outcome: The patient was counselled and re-initiated on a second-line highly active antiretroviral therapy regimen. The patient’s lesions resolved three months later.Discussion: The case is presented to improve the index of suspicion among clinicians and pathologists on such rare occurrences.

scholarly journals Pulmonary Kaposi Sarcoma: An Uncommon Cause of Respiratory Failure in the Era of Highly Active Antiretroviral Therapy—Case Report and Review of the Literature

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Stanley M. Nwabudike ◽  
Stefan Hemmings ◽  
Yonette Paul ◽  
Yordanis Habtegebriel ◽  
Octavius Polk ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Human Herpesvirus ◽  
Kaposi Sarcoma ◽  
Immune Deficiency Syndrome ◽  
Skin Lesions ◽  
Deficiency Syndrome ◽  
Cutaneous Lesions ◽  
Highly Active

Kaposi Sarcoma (KS) is the most common malignancy associated with Acquired Immune Deficiency Syndrome (AIDS) and is caused by Human Herpesvirus 8 (HHV 8) or Kaposi Sarcoma Herpesvirus (KSHV). In about 90% of cases Kaposi Sarcoma is associated with cutaneous lesions; however visceral disease can occur in the absence of cutaneous involvement. In the era of Highly Active Antiretroviral Therapy (HAART), the incidence of KS has declined. Clinical features of pulmonary KS might be difficult to distinguish from pneumonia in the immunocompromised patients and could lead to diagnostic challenges. First-line treatment of KS is with HAART and the incidence has declined with its use. Systemic chemotherapy may play a role depending on the extent of the disease. We report the case of a young man who presented with pulmonary symptoms and was later found to have pulmonary KS. Interestingly this diagnosis was made in the absence of the classic skin lesions. His disease was complicated by progressive respiratory failure and he eventually died.

Unusual aetiology of respiratory compromise in a patient with AIDS

2021 ◽  
Vol 14 (3) ◽  
pp. e240849
Author(s):  
Naji Maaliki ◽  
Aleem Azal Ali ◽  
Carmen Liliana Isache ◽  
Win Aung
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Clinical Status ◽  
Kaposi Sarcoma ◽  
Pulmonary Involvement ◽  
Empiric Therapy ◽  
Respiratory Compromise ◽  
Highly Active ◽  
Hiv Test ◽  
History Of ◽  
Bilateral Lung

A 36-year-old African American man with no medical history presented with a recent history of cough and dyspnoea. Initial chest imaging revealed diffuse bilateral lung infiltrates. A subsequent HIV test resulted positive, and he was presumptively diagnosed with AIDS, later confirmed by a CD4 of 88 cells/mm3. Empiric therapy with trimethoprim–sulfamethoxazole was initiated for presumed Pneumocystis jirovecii pneumonia. The patient’s clinical status deteriorated despite treatment. Further workup with chest CT, bronchoscopy and skin biopsy led to a diagnosis of Kaposi sarcoma with pulmonary involvement. Highly active antiretroviral therapy therapy was initiated, along with plans to start chemotherapy. However, the patient’s clinical status rapidly declined, leading to respiratory failure and eventual death. This case underlines the importance of maintaining a broad differential in immunocompromised patients presenting with respiratory symptoms.

scholarly journals Persistent Kaposi sarcoma in the era of highly active antiretroviral therapy: characterizing the predictors of clinical response

AIDS ◽  
2008 ◽  
Vol 22 (8) ◽  
pp. 937-945 ◽  
Author(s):  
Huong Q Nguyen ◽  
Amalia S Magaret ◽  
Mari M Kitahata ◽  
Stephen E Van Rompaey ◽  
Anna Wald ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Clinical Response ◽  
Highly Active Antiretroviral Therapy ◽  
Kaposi Sarcoma ◽  
Highly Active

scholarly journals Impact of valganciclovir therapy on severe IRIS-Kaposi Sarcoma mortality: an open-label, parallel, randomized controlled trial.

2021 ◽  
Author(s):  
Patricia Volkow ◽  
Leslie Chavez-Galan ◽  
Lucero Ramon-Luing ◽  
Judith Cruz-Velazquez ◽  
Patricia Cornejo-Juarez ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Kaposi Sarcoma ◽  
Pulmonary Involvement ◽  
Skin Lesions ◽  
Attributable Mortality ◽  
Control Group ◽  
Open Label ◽  
Parallel Group ◽  
Pulmonary Lymph Node ◽  
The Difference

High HHV-8 viral load (VL) in Kaposi Sarcoma (KS) has been associated with severe Immune reconstitution inflammatory syndrome (S-IRIS-KS), which can occur after initiating cART, and is linked with high mortality particularly in patients with pulmonary involvement. We investigate if valganciclovir initiated before cART decreases HHV-8 VL and assess if it reduces the incidence of S-IRIS-KS and its attributable mortality. Methods: Open-label parallel-group randomized clinical trial in AIDS cART naive patients with disseminated KS (DKS) as defined by at least two of the following: pulmonary, lymph-node or gastrointestinal involvement, lymphedema, or equal or more 30 skin lesions. In the experimental group (EG), patients were randomized to valganciclovir 900 mg BID four weeks before cART and continued until week-48; in the control group (CG), cART was initiated on week-0. Non-severe-IRIS-KS was defined as: increase in the number of lesions plus equal or more than one log10 HIV-VL decrease or equal or more than 50 cells/mm3 increase or equal or more than 2-fold rise in baseline CD4+ cells. S-IRIS-KS was defined as abrupt clinical worsening of KS lesions and/or fever after ruling out another infection following cART initiation, and at least three of the following: thrombocytopenia, anemia, hyponatremia, or hypoalbuminemia. Results: 40 patients were randomized and 37 completed the study. In the ITT analysis, the overall mortality did not differ between groups. In the per-protocol analyses, the difference showed a trend for higher S-IRIS-KS mortality in the CG 3/19 (15.7%), compared to EG 0/18 (p=0.07). The incidence of S-IRIS KS was significantly lower in the EG; two patients, one each had S-IRIS-KS episode (0.038 per 100 patient-days) compared to CG group, four patients developed 12 S-IRIS-KS episodes (0.21 per 100 patient-days); incidence rate of 0.09 (95% CI 0.02-0.5 p=0.006). Mortality in patients with pulmonary KS was significantly lower in EG, 3/4 in CG vs 0/5 in EG. S-IRIS-KS was associated with higher HHV-8-VL; IL6 and CRP; valganciclovir was protective. Of survivors at week 48, 82% achieved more than 80% remission. No difference was found between groups in the number of non-S-IRIS-KS events. Conclusions: Valganciclovir significantly reduced the episodes of S-IRIS-KS although attributable KS mortality was lower in the EG the difference was not significant (p=0.07). Mortality was significantly lower in EG patients with pulmonary KS.

Kaposi Sarcoma of the Lower Extremity with HIV and Kaposi's Sarcoma

2021 ◽  
Vol 2 (1) ◽  
pp. 01-03
Author(s):  
Selma Bakar Dertlioğlu
Keyword(s):  
Antiretroviral Therapy ◽  
Oral Cavity ◽  
Lower Extremity ◽  
Respiratory System ◽  
Kaposi's Sarcoma ◽  
Kaposi Sarcoma ◽  
Kaposi’S Sarcoma ◽  
Newly Diagnosed ◽  
Clinical Variants ◽  
Common Malignancy

Kaposi's sarcoma is the most common malignancy seen with HIV infection. It is a lymphoangioproliferous tumor first described by Moritz Kaposi in 1872. It is characterized by bluish red or dark brown plaques and nodules, especially in the distal of the lower extremities, often the heels and feet. Organ involvement without skin findings is observed in approximately 15% of the cases. There are four clinical variants, the classical, endemic, iatrogenic and the epidemic associated with AIDS. Kaposi's sarcoma in AIDS cases apart from the skin, it can also be seen in the oral cavity, gastro-intestinal system and respiratory system. Antiretroviral therapy (ART) should be started immediately in newly diagnosed HIV infected patients. In this research, a 65 year old male patient, who was diagnosed AIDS and Kaposi's sarcoma at the same time, is described.

The Response of HIV-Associated Lymphadenopathic Kaposi Sarcoma to Highly Active Antiretroviral Therapy Evaluated by 18F-FDG PET/CT

2012 ◽  
Vol 37 (7) ◽  
pp. 692-693 ◽  
Author(s):  
Satveer K. Mankia ◽  
Robert F. Miller ◽  
Simon G. Edwards ◽  
Alan Ramsay ◽  
Siow Ming Lee
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Fdg Pet ◽  
Kaposi Sarcoma ◽  
Highly Active ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

The Prevalence of HIV-1 DNA in AIDS-Related Lymphoma throughout the Epidemic in the US

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 5205-5205
Author(s):  
Leanne C Huysentruyt ◽  
Lawrence D Kaplan ◽  
Michael S. McGrath
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Conflicts Of Interest ◽  
Kaposi Sarcoma ◽  
Sequence Evolution ◽  
Genomic Amplification ◽  
Hiv Dna ◽  
Non Hodgkin Lymphoma ◽  
Highly Active ◽  
Reported Data ◽  
Hiv 1

Abstract Abstract 5205 Kaposi sarcoma (KS) and non-Hodgkin lymphoma (NHL) are the two most common AIDS-defining cancers and significantly contribute to HIV-related deaths. While highly active antiretroviral therapy (HAART) has produce a sharp decline in the incidence of KS and AIDS-related NHL (ARL), HIV-infected patients are still at a high risk for developing these malignancies. Recent studies evaluating HIV-1 DNA in 91 AIDS-related KS cases demonstrated a significant decrease in the prevalence of HIV-1 DNA positive KS cases post-HAART (after 1996; 16.7%) as compared to pre-HAART (before 1996; 45%) corresponding to the decrease in incidence of this cancer since the introduction of HAART. Additionally HIV was more prevalent in sites of visceral KS (51.9%) as compared to skin KS (30.7%). We have recently evaluated the HIV sequence evolution in the context of metastatic ARL and identified lymphoma-specific HIV compartmentalized within tumor sites that was genetically distinct from HIV in non-tumor sites suggesting a specific form of HIV arises within individuals who develop ARL. The goal of this research was to determine the prevalence and quantity of HIV DNA in 119 ARL biopsies representing the entire span of the HIV epidemic (1982–2005). Whole genomic amplification was performed on DNA extracted from three 10um paraffin embedded tissue sections and the presence of HIV-1 DNA was determined by quantitative amplification of the HIV gag gene. Of the 119 cases, 45% contained detectable levels of HIV DNA. The HIV antigen was predominantly localized to macrophages. A subset of the ARL cases in this study contained approximately 1 HIV copy per cell which is extremely high considering previously reported data describing HIV-infected lymph nodes contained approximately 1 HIV copy per 1000 cells. Similar to what was observed for KS, the prevalence of HIV-positive ARLs has decreased in the post-HAART era (39%) when compared to pre-HAART (54%). While the prevalence of HIV-1 DNA positive ARLs declined in the post-HAART era, it was not to the same extent as what was observed for KS. Thus, our data is consistent with a decrease in the incidence of both tumor types in the post-HAART era. The higher prevalence of HIV-1 DNA in visceral sites of KS and lymphoma specific-HIV sequences in sites of metastatic lymphoma suggests that HIV, especially HIV infected macrophages, may play a role in the pathogenesis of KS and ARL disease progression. Disclosures: No relevant conflicts of interest to declare.

Evolving characteristics of AIDS-related lymphoma

Blood ◽  
2000 ◽  
Vol 96 (13) ◽  
pp. 4084-4090 ◽  
Author(s):  
Alexandra M. Levine ◽  
Lasika Seneviratne ◽  
Byron M. Espina ◽  
Amy Rock Wohl ◽  
Anil Tulpule ◽  
...  
Keyword(s):  
Los Angeles ◽  
Highly Active Antiretroviral Therapy ◽  
Large Cell ◽  
The United States ◽  
Population Based ◽  
Single Institution ◽  
Highly Active ◽  
Time Period ◽  
Cd4 Lymphocyte ◽  
Aids Related Lymphoma

Over time, the epidemiologic and demographic characteristics of AIDS have changed in the United States, while the use of highly active antiretroviral therapy has changed the natural history of the disease. The goal of the study was to ascertain any changes in the epidemiologic, immunologic, pathologic, or clinical characteristics of AIDS-related lymphoma (ARL) over the course of the AIDS epidemic. Records of 369 patients with ARL diagnosed or treated at a single institution from 1982 through 1998 were reviewed. Single institutional data were compared to population-based data from the County of Los Angeles. Significant changes in the demographic profile of patients with newly diagnosed ARL have occurred, with the later time intervals associated with a higher prevalence in women (P = .25), in Latino/Hispanic individuals (P < .0001), and in those who acquired human immunodeficiency virus (HIV) heterosexually (P = .01). These changes were similar in both countywide, population-based analyses and in those from the single institution. The median CD4+ lymphocyte count at lymphoma diagnosis has decreased significantly over the years, from 177/dL in the earliest time period (1982-1986), to 53/dL in the last time period from 1995 to 1998 (P = .0006). The pathologic spectrum of disease has also changed, with a decrease in the prevalence of small noncleaved lymphoma (P = .0005) and an increase in diffuse large cell lymphoma (P < .0001). Despite changes in the use of antiretroviral or chemotherapy regimens, the median survival has not significantly changed.

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