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Kaposi’s Sarcoma in Virally Suppressed People Living with HIV: An Emerging Condition

1
Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM U1136, Sorbonne University, 75013 Paris, France
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Infectious Diseases Department, INSERM U1175, University Hospital of Montpellier, 34000 Montpellier, France
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Department of Medical Oncology, Pitié Salpêtrière Hospital, AP-HP, Institut Universitaire de Cancérologie (IUC), CLIP² Galilée, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM U1136, Sorbonne University, 75013 Paris, France
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Department of Immunology, Pitié-Salpêtrière Hospital, AP-HP, Centre d’Immunologie et des Maladies Infectieuses, INSERM U1135, Sorbonne University, 75013 Paris, France
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Service d’Immuno-hématologie Clinique, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, AP-HM, INSERM, IRD, Sciences Economiques et Sociales de la Santé et Traitement de l’Information Médicale, Hôpital Sainte-Marguerite, Aix Marseille University, 13007 Marseille, France
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Department of Pharmacology Toxicology, AP-HM, Centre de Recherche en Cancérologie de Marseille, Hospital de la Timone, INSERM, Aix-Marseille University, 13005 Marseille, France
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Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM U1136, Sorbonne University, 75013 Paris, France
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Department of Infectious and Tropical Diseases, Centre de Physiopathologie Toulouse-Purpan, Toulouse University Hospital, INSERM U1043, CNRS UMR 5282, 31300 Toulouse, France
*
Author to whom correspondence should be addressed.
Academic Editor: Naoki Mori
Cancers 2021, 13(22), 5702; https://doi.org/10.3390/cancers13225702
Received: 19 October 2021 / Revised: 6 November 2021 / Accepted: 9 November 2021 / Published: 15 November 2021
(This article belongs to the Special Issue Perspectives on Kaposi's Sarcoma)
Kaposi’s sarcoma (KS) in people living with HIV (PLHIV) occurs in the vast majority of cases when viral replication is not controlled and when CD4 immunosuppression is important. However, clinicians are observing more and more cases of KS in PLHIV with suppressed viremia on antiretroviral treatment. These clinical forms seem less aggressive, but cause therapeutic dead ends. Indeed, despite repeated chemotherapy, recurrences are frequent. Immunotherapy and specific treatment regimens should be evaluated in this population.
Since the advent of highly effective combined antiretroviral treatment (cART), and with the implementation of large HIV testing programs and universal access to cART, the burden of AIDS-related comorbidities has dramatically decreased over time. The incidence of Kaposi’s sarcoma (SK), strongly associated with HIV replication and CD4 immunosuppression, was greatly reduced. However, KS remains the most common cancer in patients living with HIV (PLHIV). HIV physicians are increasingly faced with KS in virally suppressed HIV-patients, as reflected by increasing description of case series. Though SK seem less aggressive than those in PLHIV with uncontrolled HIV-disease, some may require systemic chemotherapy. Persistent lack of specific anti-HHV-8 cellular immunity could be involved in the physiopathology of these KS. These clinical forms are a real therapeutic challenge without possible short-term improvement of anti-HHV-8 immunity, and no active replication of HIV to control. The cumulative toxicity of chemotherapies repeatedly leads to a therapeutic dead end. The introduction or maintenance of protease inhibitors in cART does not seem to have an impact on the evolution of these KS. Research programs in this emerging condition are important to consider new strategies. View Full-Text
Keywords: Kaposi’s sarcoma; HIV; AIDS; antiretroviral; cancer Kaposi’s sarcoma; HIV; AIDS; antiretroviral; cancer
MDPI and ACS Style

Palich, R.; Makinson, A.; Veyri, M.; Guihot, A.; Valantin, M.-A.; Brégigeon-Ronot, S.; Poizot-Martin, I.; Solas, C.; Grabar, S.; Martin-Blondel, G.; Spano, J.-P. Kaposi’s Sarcoma in Virally Suppressed People Living with HIV: An Emerging Condition. Cancers 2021, 13, 5702. https://doi.org/10.3390/cancers13225702

AMA Style

Palich R, Makinson A, Veyri M, Guihot A, Valantin M-A, Brégigeon-Ronot S, Poizot-Martin I, Solas C, Grabar S, Martin-Blondel G, Spano J-P. Kaposi’s Sarcoma in Virally Suppressed People Living with HIV: An Emerging Condition. Cancers. 2021; 13(22):5702. https://doi.org/10.3390/cancers13225702

Chicago/Turabian Style

Palich, Romain, Alain Makinson, Marianne Veyri, Amélie Guihot, Marc-Antoine Valantin, Sylvie Brégigeon-Ronot, Isabelle Poizot-Martin, Caroline Solas, Sophie Grabar, Guillaume Martin-Blondel, and Jean-Philippe Spano. 2021. "Kaposi’s Sarcoma in Virally Suppressed People Living with HIV: An Emerging Condition" Cancers 13, no. 22: 5702. https://doi.org/10.3390/cancers13225702

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