Manifestations, diagnosis and treatment of disseminated Kaposi's sarcoma: A literature review
DOI:
https://doi.org/10.33448/rsd-v13i11.47533Keywords:
Kaposi's Sarcoma; Immune Reconstitution Inflammatory Syndrome; HIV Infections.Abstract
Kaposi's sarcoma is a multifocal mesenchymal neoplasm caused by human herpesvirus type 8, which has an incidence associated with Human Acquired Immunodeficiency Syndrome and is one of the AIDS-defining diseases. It presents neo-angiogenesis, inflammatory infiltration, vascular lesions, and endothelial involvement, associated with more frequent mucocutaneous involvement and possible involvement of viscera and lymph nodes. It has a more aggressive presentation related to human immunodeficiency syndrome, with the potential participation of the gastrointestinal tract, lungs, oral mucosa, and genitalia. The clinical history and the appearance of characteristic skin lesions, with specific histopathological findings on biopsy, are the basis for the diagnosis. In the therapeutic approach for cases of association between Kaposi's sarcoma and AIDS, antiretroviral therapy is used for all patients, regardless of CD4 count, reserving chemotherapy for patients with advanced-stage disease, or in cases of evidence of rapid progression. This study aims to present a narrative review of the literature that seeks to broaden the debate on the subject from the perspective of studying disseminated Kaposi's sarcoma after initiating antiretroviral therapy. The advent of antiretroviral therapy in controlling HIV infection can lead to a significant reduction in the incidence and aggressiveness of Kaposi's sarcoma, and paradoxically, ART itself also participates in the process of manifestation of the disease, contextualizing the Immune Reconstitution Inflammatory Syndrome.
References
Arora, M.; Goldberg, E.M. (2010) Kaposi Sarcoma involving the gastrointestinal tract. Gastroenterology and Hepatology, 6(7), 459-462.
Arruda, E. et al. (2014), Consensus of the Brazilian Society of Infectious Diseases and Brazilian Society of Clinical Oncology on the management and treatment of Kaposi's sarcoma. Braz J Infect Dis. 18(3), 315-26.
Achenbach, C.J. et al. (2012), Paradoxical immune reconstitution inflammatory syndrome in HIV-infected patients treated with combination antiretroviral therapy after AIDS-defining opportunistic infection. Clin Infect Dis. 54(3), 424-33.
Bower, M. et al. (2005) Immune reconstitution inflammatory syndrome associated with Kaposi’s sarcoma. J Clin Oncol. 23, 5224–8.
Bower, M. et al. (2008) AIDS malignancy subcommittee. British HIV association guidelines for HIV-associated malignancies 2008. HIV Med. 9, 336–88.
Brasil. (2013). Protocolo clínico e diretrizes terapêuticas para manejo da infecção pelo HIV em adultos. Brasília. Ministério da Saúde/Secretaria de Vigilância em Saúde. Departamento de DST, Aids e Hepatites Virais.
Brasil. (2013). SINAN – Sistema de Informacão de Agravos de Notificação. Ministério da Saúde.
Cavalcante, L. T. C. & Oliveira, A. A. S. (2020). Métodos de revisão bibliográfica nos estudos científicos. Psicol. Rev. 26(1).
Casarin, S. T. et al. (2020). Tipos de revisão de literatura: considerações das editoras do Journal of Nursing and Health. Journal of Nursing and Health,10(5).
Cheung, T.W. (2004) AIDS-related cancer in the era of highly activeantiretroviral therapy (HAART): a model of the interplay of the immune system, virus, and cancer. On the offensive – The Trojan Horse is being destroyed – Part A: Kaposi’s sarcoma. Cancer Invest. 22, 774–86.
Cianfrocca, M. et al. (2010) Randomized trial of paclitaxel versus pegylated liposomal doxorubicin for advanced human immunodeficiency virus-associated Kaposi sarcoma: evidence of symptom palliation from chemotherapy. Cancer. 116(16), 3969.
Di Monta, G. et. al. (2014) Electrochemotherapy as "new standard of care" treatment for cutaneous Kaposi's sarcoma. Eur J Surg Oncol. 40(1), 61.
Dittmer, D.P.; Damania, B. (2016), Kaposi sarcoma-associated herpesvirus: immunobiology, oncogenesis, and therapy. J Clin Invest. 126(9), 3165-75.
Ferreira, J. P.; Miskolci, R. (2022) “Reservatórios de doenças venéreas”, “MSM/HSH” e “PWA”: continuidades, rupturas e temporalidades na produção de bioidentidades no contexto da epidemia de AIDS. Ciência & Saúde Coletiva, 27(9), 3461-3474.
Fernández-Sánchez, M. et al. (2016), Steroids are a risk factor for Kaposi's sarcoma-immune reconstitution inflammatory syndrome and mortality in HIV infection. AIDS. 27;30(6), 909-14.
Fonseca, B.A.L.; Bolella, V.R.; Neto, R.J.P. (1999) Sarcoma de Kaposi e Síndrome da Imunodeficiência Adquirida: características desta associação, incluindo novos conceitos sobe patogênese e tratamento. Medicina, Ribeirão Preto. 32, 26-39.
Friedland, G.H. et al. (2013), Case records of the Massachusetts General Hospital. Case 29-2013. A 32-year-old HIV-positive African man with dyspnea and skin lesions. N Engl J Med. 369(12), 1152-61.
Gallafent, J.H. et al. (2005) Profile of patients with Kaposi’s sarcoma in the era of highly active antiretroviral therapy. J Clin Oncol. 23, 1253–60.
Gasparetto, T.D. et.al. (2009) Pulmonary involvement in Kaposi Sarcoma: correlation between image and pathology. Orphanet J Rare Dis. 4, 18.
Gill, P.S. et al. (1996) Randomized phase III trialof liposomal daunorubicin versus doxorubicin, bleomycin,and vincristine in AIDS-related Kaposi’s sarcoma. J ClinOncol. 14, 2353–64.
Grabar, S. et al. (2006) Differential impact of combination antiretroviral therapy in preventing Kaposi’s sarcoma with and without visceral involvement. J Clin Oncol. 24, 3408–14.
Holkova, B. et al. (2001) Effect of highly active antiretroviral therapy on survival in patients with AIDS-associated pulmonary Kaposi’s sarcoma treated with chemotherapy. J Clin Oncol. 19, 3848–51.
Hoskote, S.S.; Patel, V.P. (2012) Pulmonary Kaposi Sarcoma in AIDS. Mayo Clin Proc. 87(10), 77.
Hauerstock, D.; Gerstein, W.; Vuong, T. (2009) Results of radiation therapy for treatment of classic Kaposi sarcoma. J Cutan Med Surg. 13(1), 18.
Jaffe, H.W. et al. (2011) Immune reconstitution and risk of Kaposi sarcoma and non-Hodgkin lymphoma in HIV-infected adults. CASCADE Collaboration. AIDS. 25(11), 1395-403.
Janusch, M. et al. (2006) The hand-foot syndrome – a frequent secondary manifestation in antineoplastic chemotherapy. Eur J Dermatol. 16, 494–9.
Koon, H.B. et al. (2014) Phase II trial of imatinib in AIDS-associated Kaposi's sarcoma: AIDS Malignancy Consortium Protocol 042. J Clin Oncol. 32(5), 402.
Lacombe, J. M. et.al. (2013), Risk of Kaposi sarcoma during the first months on combination antiretroviral therapy. AIDS. 27(4), 635-43.
Lee, A.J. et al. (2015) Kaposi’s Sarcoma: case report and review of the literature. World J Gastrointest Pharmacol Ther. 6(3), 89-95.
Letang, E. et al. (2010) Predictors of immune reconstitution inflammatory syndrome-associated with kaposi sarcoma in mozambique: a prospective study. J Acquir Immune Defic Syndr. 53(5), 589-97.
Little, R.F. et al. (2007) Phase 2 study of pegylated liposomal doxorubicin in combination with interleukin-12 for AIDS-related Kaposi sarcoma. Blood. 110(13), 4165.
Lodi, S. et al. (2010) CASCADE Collaboration. J Natl Cancer Inst. 102(11), 784.
Lodi, S. et al. (2014) Opportunistic infections and AIDS malignancies early after initiating combination antiretroviral therapy in high-income countries. The HIV-CAUSAL Collaboration. AIDS. 23;28(16), 2461-73.
Manzardo, C. et al. (2015) Opportunistic infections and immune reconstitution inflammatory syndrome in HIV-1-infected adults in the combined antiretroviral therapy era: a comprehensive review. Expert Rev Anti Infect Ther. 13(6), 751-67.
Marques, S.A. (2005) Sarcomatose múltipla hemorrágica de Kaposi. An. Bras. Dermatol. 80(5), 549-552.
Martin, J.N. et al. (1998) Sexual transmission and the natural history of human herpesvirus 8 infection. N Engl J Med. 338(14), 948.
Martins-de-Barros, A.V.; Carvalho, M.V.; Araújo, F.A.C. (2023). AIDS-related Kaposi sarcoma of the oral cavity. Revista Da Sociedade Brasileira De Medicina Tropical, 56, e0133–2023.
McAllister, S.C.; Hanson, R.S.; Manion, R.D. (2015) Propranolol Decreases Proliferation of Endothelial Cells Transformed by Kaposi's Sarcoma-Associated Herpesvirus and Induces Lytic Viral Gene Expression. J Virol. 89(21), 11144.
Mosam, A. et al. (2012) A randomized controlledtrial 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. 60, 150–7.
Nagata, N. et.al. (2012) Predictive clinical factors in the diagnosis of gastointestinal Kaposi’s Sarcoma and its endoscopic severity. PLoS One, 7, 46967.
Nazzaro, G. et al. (2022). Dermoscopy and ultrasonography of Kaposi’s sarcoma nodules: new insights to guide intralesional chemotherapy? Anais Brasileiros De Dermatologia, 97(5), 665–667.
Oluwatoyin, F.G. et al. (2014), Treatment of severe or progressive Kaposi's sarcoma in HIV-infected adults. Cochrane Database Syst Rev., (9), CD003256.
Pereira A. S. et al. (2018). Metodologia da pesquisa científica. [free e-book]. Santa Maria/RS. Ed. UAB/NTE/UFSM.
Pinheiro, C. G. et al. (2023). Rapidly progressive Kaposi’s sarcoma associated with human immunodeficiency syndrome. Anais Brasileiros De Dermatologia, 98(2), 272–275.
Pinzone, M.R. et al. (2015) Epstein Barr Virus- and Kaposi Sarcoma- Associated Herpesvirus- Related Malignances in the Setting of Human Immunodeficiency Virus Infection. Semin Oncol. 42(2), 258-71.
Polizzotto, M.N. et al. (2016) Pomalidomide for Symptomatic Kaposi's Sarcoma in People With and Without HIV Infection: A Phase I/II Study. J Clin Oncol. 34(34), 4125.
Radu, O.; Pantanowitz, L. (2013) Kaposi Sarcoma-Short Review. Arch Pathol Lab Med. 137, 289-294.
Raimundo, K. et al. (2013) Cost effectiveness of liposomal doxorubicin vs. paclitaxel for the treatment of advanced AIDS-Kaposi’s sarcoma. Journal of Medical Economics. 16(5), 606-613.
Robey, C.; Bower, M. (2015), Facing up to the ongoing challenge of Kaposi's sarcoma. Curr Opin Infect Dis. 28(1), 31-40.
Rother, E. T. (2007). Revisão sistemática x revisão narrativa. Acta paul. enferm. 20(2).
Stiller, C.A. et al. (2014) Descriptive epidemiology of Kaposi sarcoma in Europe. Report from the RARECARE project. Cancer Epidemiol. 38(6), 670-8.
Tancredi, M.V. et al. (2017) Prevalence of Kaposi's sarcoma in patients with AIDS and associated factors, São Paulo-SP, Brazil, 2003-2010. Epidemiol. Serv. Saude. 26(2), 379-387.
Uldrick, T.S. et al. (2012) Phase II study of bevacizumab in patients with HIV-associated Kaposi's sarcoma receiving antiretroviral therapy. J Clin Oncol. 30(13), 1476.
Yoo, D.J. et al. (2005) Clinical and bronchoscopic findings in Ugands with Pulmonary Kaposi’s Sarcoma. Korean J Intern Med. 20(4), 290.
Wang, T.; Liron Pantanowitz, L.D. (2013) Recent advances in Kaposisarcoma. J Oncopathol. 1–12.
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