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Kaposi Sarcoma — SCE Infectious Diseases MCQ

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ModerateHIV MedicineKaposi SarcomaSCE Infectious Diseases

A 38-year-old man with HIV (CD4 120 cells/µL) not on ART presents with painless violaceous raised lesions on his hard palate and disseminated cutaneous lesions. Biopsy confirms HHV-8-positive Kaposi sarcoma with pulmonary involvement on CT. What is the most appropriate treatment?

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Correct answer: C — Initiate ART and commence liposomal Doxorubicin chemotherapy

AIDS-associated Kaposi sarcoma with visceral (pulmonary) involvement is advanced-stage disease requiring both ART initiation for immune reconstitution and systemic chemotherapy. Liposomal pegylated Doxorubicin is first-line chemotherapy. ART alone may be sufficient for limited cutaneous disease without visceral involvement. KS-IRIS (paradoxical worsening after ART) can occur and should be anticipated.

Reference: BHIVA 2022 – HIV-associated malignancy guidelines; NICE 2023 – KS management