Therapeutic Outcomes in AIDS-Associated Kaposi's Sarcoma Patients on Antiretroviral Therapy Treated with Chemotherapy at Two Tertiary Hospitals in Lusaka, Zambia

Abstract

ABV chemotherapy appears ineffective in long-term resolution of epidemic KS patients on ART. Recurrence rates are high after chemotherapy in patients that experience initially favorable responses to treatment. There is a need to diagnose KS earlier, and to develop more efficacious treatment options in order to reduce recurrence rates for epidemic KS.

Viral and Immunological Analytes are Poor Predictors of the Clinical Treatment Response in Kaposi’s Sarcoma Patients

“…This implies that the response requires modulation of the qualitative or functional aspects of immune control. The lack of significant changes potentially explains the short-lived clinical responses and high recurrence rates reported in other studies [13,21]. As suggested by Roshan et al, weak, and individualized T-cell functional responses (IFN-γ) against KSHV, coupled with a lack of immunodominant epitopes, seem to be common features in participants with KS and in asymptomatic controls [47].…”

“…We have quantified KSHV and HIV-1 viremia, KSHV-humoral responses, cytokine expression, and T-cell immunophenotypes before and after treatment to identify factors that correlate with the KS clinical response, or lack thereof. An advanced cancer stage is known to correlate with poor treatment outcome [19][20][21][22]. In contrast, early diagnosis and treatment associates with improved clinical response and reduced morbidity [16][17][18].…”

“…KS treatment in SSA consists of conventional chemotherapy and/or radiotherapy [19][20][21][22]. The readily available KS treatments are suboptimal with no curative effects [17,21,23]. First-line KS treatments employed in developed countries, such as liposomal doxorubicin, alone or in combination with other drugs, are not readily accessible [24].…”

“…First-line KS treatments employed in developed countries, such as liposomal doxorubicin, alone or in combination with other drugs, are not readily accessible [24]. With currently available KS treatments, approximately 50% of African participants with KS achieve some degree of remission [17,21]. Unfortunately, approximately 50% of initially remitting patients experience recurrence within 6 months post-treatment [21].…”

“…With currently available KS treatments, approximately 50% of African participants with KS achieve some degree of remission [17,21]. Unfortunately, approximately 50% of initially remitting patients experience recurrence within 6 months post-treatment [21]. Factors that correlate with KS treatment responses are not currently understood.…”