Doctors in San
Francisco have reported an outbreak among long-term AIDS
patients of Kaposi's sarcoma, the viral skin disease whose
purple lesions were a telltale sign of advancing
disease before drugs were developed to treat the
epidemic.
The 15 patients
under treatment are all doing well on antiretroviral
therapy, and none is in danger, Toby Maurer, chief of
dermatology at San Francisco General Hospital, told
the
San Francisco Chronicle.
Unlike the
Kaposi's of the 1980s, the condition does not appear to
spread to internal organs or to be a harbinger of
declining health, Maurer said.
Still, the
condition's recurrence is puzzling. Doctors think some other
virus or latent infection may trigger HHV-8, the herpes
virus that causes Kaposi's, in otherwise stable
patients.
Kaposi's was
originally seen almost exclusively in older Mediterranean
men; the new outbreaks appear to be much like the earlier,
more benign form of the disease.
"This is nothing
like what we saw 25 years ago," dermatologist Marcus
Conant, who discovered the first clusters of Kaposi's
patients at that time, told the
Chronicle.
In addition to
systemic AIDS drugs, the new patients have been treated
topically with liquid nitrogen or injections of chemotherapy
drugs to remove the lesions, the newspaper said.
"The normal
treatment for KS among HIV patients is to treat the virus
and boost the immune system," Maurer told the
Chronicle.
"But in these patients, their immune
system is already boosted."
Maurer described
the cases in a letter published September 27 in
The
New England Journal of Medicine.
The patients'
average age is 51; they have been HIV-positive for 18
years, on average, and have been on antiretrovirals for
seven. They were diagnosed with Kaposi's between
November 2004 and January 2006. (Barbara Wilcox,
The Advocate
)
