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Open AccessArticle

Impact of Antiretroviral Therapy on the Risk of Recurrence in HIV-1 Infected Patients with Kaposi Sarcoma: A Multicenter Cohort Experience

1
Infectious Dermatology and Allergology, San Gallicano Dermatological Institute IRCCS, 00144 Rome, Italy
2
Clinical Infectious Diseases, Catholic University of S. Heart, 00168 Rome, Italy
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Unit of Infectious Diseases, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari Italy
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Department of Medical Biotechnologies, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy
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Infectious Diseases Unit, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy
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UOC Malattie Infettive, 03100 Frosinone, Italy
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Plastic Surgery, San Gallicano Dermatological Institute IRCCS, 00144 Rome, Italy
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First Division of Medical Oncology, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
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UOSD AIDS, 03100 Frosinone, Italy
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AOU S Andrea, 00189 Rome, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(12), 2062; https://doi.org/10.3390/jcm8122062
Received: 2 November 2019 / Revised: 19 November 2019 / Accepted: 21 November 2019 / Published: 23 November 2019
Kaposi sarcoma (KS) remains a relevant malignancy in human immunodeficiency virus (HIV)-infected patients with a non-standardized management; despite past suggestions that ritonavir-boosted protease inhibitor (bPI)-based regimens could be preferable, no combination antiretroviral therapy (cART) regimen was demonstrated to outperform the others and the impact of new drugs, drug classes or paradigms was never investigated nor proven better than previous therapeutic regimes. In order to do this, we retrospectively collected data regarding HIV-infected patients with a diagnosis of KS last seen in six Italian centers after 1 January 2013. A total of 104 KS cases in 99 patients was analyzed for 945.34 patient-year follow-up (PYFU). Twenty-six patients had visceral localizations. Thirty-three patients were treated with chemotherapy, four with electrochemotherapy, and 12 with α-interferon (α-IFN). At censor, 22% received a bPI-based, 14% a non-nucleoside reverse transcriptase inhibitor (NNRTI)-based, and 28% an integrase inhibitor (INI)-based standard cART, 24% a less drug regimen and 12% a mega-cART. Twelve recurrence episodes were observed in seven patients for an incidence of 1.27 per 100 PYFU. Two patients with no evidence of recurrence episodes died for other reasons. In our experience, KS recurrence episodes were infrequent. Despite the increasing use of new antiretroviral drug classes and new treatment paradigms, no excess of recurrence episodes was observed in patients receiving such cART regimens. View Full-Text
Keywords: HIV infection; acquired immunodeficiency syndrome (AIDS); Kaposi sarcoma HIV infection; acquired immunodeficiency syndrome (AIDS); Kaposi sarcoma
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Colafigli, M.; Ciccullo, A.; Borghetti, A.; Fanti, I.; Melis, F.; Modica, S.; Uccella, I.; Bonadies, A.; Ferraresi, V.; Anzalone, E.; Pennica, A.; Migliano, E.; Rossetti, B.; Madeddu, G.; Cauda, R.; Cristaudo, A.; Di Giambenedetto, S.; Latini, A. Impact of Antiretroviral Therapy on the Risk of Recurrence in HIV-1 Infected Patients with Kaposi Sarcoma: A Multicenter Cohort Experience. J. Clin. Med. 2019, 8, 2062.

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