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Current HIV Research

Editor-in-Chief

ISSN (Print): 1570-162X
ISSN (Online): 1873-4251

Research Article

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

Author(s): Watson Mtonga, Aaron Mujajati, Derick Munkombwe, Aubrey Kalungia, Lungwani Tyson Muungo, John West, Charles Wood and Owen Ngalamika*

Volume 16, Issue 3, 2018

Page: [231 - 236] Pages: 6

DOI: 10.2174/1570162X16666180711103610

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Abstract

The incidence of HIV-associated Kaposi’s sarcoma (KS) remains high in Zambia in the antiretroviral therapy era. The most efficacious treatment regimen for KS has yet to be established. In both developed and developing countries, treatment regimens have had limited efficacy. Late presentation in Africa affects therapeutic outcomes.

Objective: The aim of this study was to determine therapeutic outcomes of epidemic KS patients on combination antiretroviral therapy (cART) after completion of six cycles of Adriamycin, Bleomycin, and Vincristine (ABV) chemotherapy.

Methods: This was a descriptive cross-sectional study. Study participants were drawn from a study database of confirmed incident KS patients seen at the Skin Clinic of the University Teaching Hospitals (UTH) during the period between August, 2015 and September, 2016.

Results: Of the 38 successfully recruited study participants, a complete response was documented in 18 (47%) after 6 cycles of ABV whereas 20 (53%) experienced a partial response. KS recurrence was observed in 8 (44%) of the individuals that experienced an initial complete response. At the time of the study, clinical assessment revealed that KS lesions had completely regressed in 21 (55%) of all the patients.

Conclusion: 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.

Keywords: Kaposi`s Sarcoma, HIV-associated, treatment, chemotherapy, outcomes, recurrence.

Graphical Abstract
[1]
Mosam A, Uldrick TS, Shaik F, Carrara H, Aboobaker J, Coovadia H. An evaluation of the early effects of a combination antiretroviral therapy programme on the management of AIDS-associated Kaposi’s sarcoma in KwaZulu-Natal, South Africa. Int J STD AIDS 2011; 22(11): 671-3.
[2]
Ngalamika O, Minhas V, Wood C. Kaposi’s sarcoma at the University Teaching Hospital, Lusaka, Zambia in the antiretroviral therapy era. Int J Cancer 2015; 136(5): 1241-2.
[3]
Robey RC, Bower M. Facing up to the ongoing challenge of Kaposi’s sarcoma. Curr Opin Infect Dis 2015; 28(1): 31-40.
[4]
Makombe SD, Harries AD, Yu JK, et al. Outcomes of patients with Kaposi’s sarcoma who start antiretroviral therapy under routine programme conditions in Malawi. Trop Doct 2008; 38(1): 5-7.
[5]
GLOBOCAN, Estimated Cancer Incidence, Mortality and Prevalence Worldwide. WHO 2012.
[6]
Engels EA, Pfeiffer RM, Goedert JJ, et al. Trends in cancer risk among people with AIDS in the United States 1980-2002. AIDS 2006; 20(12): 1645-54.
[7]
Mosam A, Aboobaker J, Shaik F. Kaposi’s sarcoma in sub-Saharan Africa: a current perspective. Curr Opin Infect Dis 2010; 23(2): 119-23.
[8]
Schwartz RA, Micali G, Nasca MR, Scuderi L. Kaposi sarcoma: a continuing conundrum. J Am Acad Dermatol 2008; 59(2): 179- 206; 7-8.
[9]
Krown SE. Treatment strategies for Kaposi sarcoma in sub-Saharan Africa: challenges and opportunities. Curr Opin Oncol 2011; 23(5): 463-8.
[10]
Northfelt DW, Dezube BJ, Thommes JA, et al. Pegylated-liposomal doxorubicin versus doxorubicin, bleomycin, and vincristine in the treatment of AIDS-related Kaposi’s sarcoma: results of a randomized phase III clinical trial. J Clin Oncol 1998; 16(7): 2445-51.
[11]
Gbabe OF, Okwundu CI, Dedicoat M, Freeman EE. Treatment of severe or progressive Kaposi’s sarcoma in HIV-infected adults. Cochrane Database Syst Rev 2014; (8): CD003256.
[12]
Nunez M, Saballs P, Valencia ME, et al. Response to liposomal doxorubicin and clinical outcome of HIV-1-infected patients with Kaposi’s sarcoma receiving highly active antiretroviral therapy. HIV Clin Trials 2001; 2(5): 429-37.
[13]
Mosam A, Shaik F, Uldrick TS, et al. A randomized controlled trial of highly active antiretroviral therapy versus highly active antiretroviral therapy and chemotherapy in therapy-naive patients with HIV-associated Kaposi sarcoma in South Africa. J Acquir Immune Defic Syndr 2012; 60(2): 150-7.
[14]
Nguyen HQ, Magaret AS, Kitahata MM, Van Rompaey SE, Wald A, Casper C. Persistent Kaposi sarcoma in the era of highly active antiretroviral therapy: characterizing the predictors of clinical response. AIDS 2008; 22(8): 937-45.
[15]
Steegmann JL, Sanchez Torres JM, Colomer R, et al. Prevalence and management of anaemia in patients with non-myeloid cancer undergoing systemic therapy: a Spanish survey. Clin Transl Oncol 2013; 15(6): 477-83.
[16]
Gwaram BA, Yusuf SM. Clinical presentation and treatment outcome of HIV associated Kaposi sarcoma in a tertiary health centre in Nigeria. J Med Res 2016; 2(4): 110-3.

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