Antiretroviral Therapy for Kaposi Sarcoma

Antiretroviral medications can help boost the immune system and slow or prevent the HIV virus from progressing to acquired immunodeficiency syndrome (AIDS). They can shrink existing Kaposi sarcoma lesions and help prevent the cancer from spreading.

Antiretroviral therapy alone is typically used in people with HIV if their doctor considers them to be in a “good risk” category, meaning their immune systems are functioning well and Kaposi sarcoma has not spread widely. Specifically, “good risk” usually means that a person’s levels of CD4—which are white blood cells that help fight infection—are more than 200 cells per microliter. In people with HIV and Kaposi sarcoma who are at good risk, the lesions are confined to the skin or lymph nodes, and any oral lesions are limited to the roof of the mouth.

People with HIV and Kaposi sarcoma in the good risk category also do not have any other bacterial, viral, or fungal infections or significant symptoms, such as fever, weight loss, or diarrhea. All of these suggest that an underlying infection is present. These people may benefit from local therapies, which help destroy skin and mouth lesions.

People with HIV and Kaposi sarcoma who are in the “poor risk” category may need to take antiretrovirals in combination with additional medications that attack cancer cells throughout the body. “Poor risk” indicates that a person’s CD4 levels are less than 200 cells per microliter. He or she also usually has more extensive cancer, with lesions occurring throughout the mouth or in the gastrointestinal tract or lungs. Lymphedema is often a symptom of more advanced Kaposi sarcoma.

People in the poor risk category may have other bacterial, viral, or fungal infections because of a weakened immune system or symptoms such as night sweats, fever, weight loss, or diarrhea, which may indicate an underlying illness is present.