HIV and Kaposi’s sarcoma
People with immune systems weakened by HIV are at a higher risk of developing a rare cancer called Kaposi's sarcoma (KS).
HIV-related Kaposi's sarcoma has become less common with improvements in antiretroviral therapy for HIV.
Kaposi’s sarcoma mainly affects the skin, mouth and lymph nodes.
How Kaposi's sarcoma develops
Kaposi's sarcoma is caused by a herpes virus, called Human Herpes Virus 8 (HHV-8), or Kaposi sarcoma associated herpesvirus (KSHV). It affects 8 times more men than women. Keeping your immune system strong with antiretroviral therapy (called HAART) is the best-known way to prevent Kaposi's sarcoma.
Kaposi's sarcoma creates tumours below skin surfaces and in membranes of the mouth, nose, anus, or eyes. It can spread to the lungs, liver, stomach, intestines, or lymph nodes. This involves a process called angiogenesis, where tiny new blood vessels form.
Symptoms of Kaposi's sarcoma
The most visible signs of Kaposi's sarcoma are lesions on the skin, which are not life threatening.
- These are flat and painless, aren't itchy, and don't drain.
- They appear as red or purple spots on white skin and bluish, brownish, or black on dark skin.
- They may grow into raised bumps or grow together. They don't turn paler when you press on them.
- In some people, these growths change slowly. In others, new spots may show up each week.
If KS spreads elsewhere, it can cause other symptoms and can be life threatening. These are symptoms that may develop:
Diagnosing Kaposi's sarcoma
All it may take to diagnose Kaposi's sarcoma is looking at the skin. Your doctor may remove a sample of tissue from a spot and examine it under a microscope. This is called a biopsy, and can confirm the diagnosis. If you have respiratory symptoms, your doctor may use bronchoscopy to view your breathing passages with a lighted tube. Or, if you have gastrointestinal symptoms, your doctor may use endoscopy to view your gastrointestinal system with a lighted tube.
Treating Kaposi's sarcoma
In many cases, HAART, or combination antiretroviral therapy, is the best way to treat active Kaposi's sarcoma. It may even clear up the skin lesions. These are other types of treatment you may need.
Local treatment. If you have just a few skin lesions, you may decide to have them removed. This does not cure Kaposi's sarcoma, but can greatly improve your appearance. This can be done in one of these ways:
- Freezing with liquid nitrogen
- Radiation treatment
- Surgical removal
- Injection with anti- cancer drugs or alpha interferon
Systemic chemotherapy. To treat Kaposi's sarcoma that has spread to internal organs, you need drugs that treat your whole body. This is called systemic treatment. If HAART, or combination antiretroviral therapy, is not effective, your doctor may prescribe anti-cancer drugs called chemotherapy.
Biological therapy. Produced by the body's own immune system, alpha interferon is one common type of biological therapy. Your doctor may prescribe it if your CD4 cell count is over 200 and you have a fairly healthy immune system. It works by activating your immune system to attack viruses and by preventing viruses from reproducing.