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June 16, 2008
Scoring Tool Helps Predict KS Worsening
A simple scoring tool is able to predict which HIV-positive patients with the AIDS-related Kaposi’s sarcoma (KS) are most likely to see their cancer progress, according to a study published in the May 31 issue of AIDS, and reported byAIDSmap.
KS, which is caused by the human herpes virus-8 (HHV-8), was once a common skin cancer in people with HIV. Though antiretroviral (ARV) treatment is one of the most effective measures a person can take to keep KS at bay, a small percentage of people develop new lesions or worsening KS symptoms despite the use of ARV therapy. And until recently, there haven’t been any tools to help predict which HIV-positive people with KS are likely to respond well to ARV treatment alone or those who will require therapy specifically for their lesions.
In designing such a tool, Emmanuelle Boffi El Amari, MD, from the Geneva University Hospital in Switzerland, and her colleagues found three variables that increased the risk for KS disease progression, after conducting an analysis of stored blood samples from 144 patients diagnosed with KS in the Swiss HIV Cohort study.
The first variable was disease staging. As might be expected, those initially diagnosed with more widespread and aggressive symptoms, classified as disease stage T1, were five times more likely to have disease progression than those classified with the less severe disease stage T0.
Second, people with a CD4 count of less than 200 were twice as likely as people with a higher CD4 count to have KS progression. Third, people who had detectable levels of HHV-8 were also twice as likely to have KS progression as people with no detectable HHV-8.
Boffi El Amari’s team writes that going forward, physicians can give a score of two points to people with a disease stage of T1, and one point each to people with either a low CD4 count or detectable HHV-8 levels. People with a score of two or more would be most likely to have KS progression and thus, most likely to need KS chemotherapy.
