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. 2022 Mar;23(3):301-306.
doi: 10.1111/hiv.13168. Epub 2021 Oct 19.

No increased risk of Kaposi sarcoma relapse in patients with controlled HIV-1 infection after switching protease inhibitor-based antiretroviral therapy

Rébecca Lajaunie  1 , Lise Cuzin  2 , Romain Palich  3 , Alain Makinson  4 , Firouzé Bani-Sadr  5 , Claudine Duvivier  6 , Cedric Arvieux  7 , David Rey  8 , Isabelle Poizot-Martin  9 , Cyril Delpierre  10 , Pierre Delobel  11 , Guillaume Martin-Blondel  11 ; And The Dat’AIDS study group
Collaborators, Affiliations
Free article

No increased risk of Kaposi sarcoma relapse in patients with controlled HIV-1 infection after switching protease inhibitor-based antiretroviral therapy

Rébecca Lajaunie et al. HIV Med. 2022 Mar.
Free article

Abstract

Objectives: Our aim was to assess if switching from a protease inhibitors (PI)-based regimen to a PI-free one is associated with an increased risk of Kaposi Sarcoma (KS) relapse among patients living with HIV (PLHIV) with history of KS and controlled HIV replication.

Methods: In a retrospective analysis of the prospectively collected Dat'AIDS database we selected patients who both had a past KS history and a HIV-1 viral load below 200 copies/mL while being PI-treated. We searched for KS relapses while persistent virological success was maintained for at least 6 months, whether patients kept taking the PI, or switched to PI-free regimen.

Results: Among the 216 patients with past KS event and a history of HIV-1 infection efficiently treated by a PI-based regimen, 148 patients (68.5%) later switched to a PI-sparing regimen. Their baseline characteristics were not different from non-switching patients. We described 7 cases of relapse (3.2% of the 216 patients). Five cases of relapse occurred in switching patients (3.4%). The remaining two relapses occurred in PI-treated patients (2.9%). At KS relapse, CD4 cell count was 459 cells/μL (range 225-560) for switching patients, compared with 362 and 136 cells/μL for the other two patients.

Conclusions: In this large cohort of PLHIV with a history of KS and ART-controlled HIV replication, KS relapses were described in 3.2% of the patients, and were not more frequent when a PI-containing ART regimen has been switched to a PI-free regimen. Our results do not support a specific effect of PI on KS.

Keywords: AIDS; HHV8; Kaposi sarcoma; antiretroviral therapy; protease inhibitors; switch.

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References

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