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Kaposi Sarcoma — SCE Infectious Diseases MCQ

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ModerateHIV MedicineKaposi SarcomaSCE Infectious Diseases

A 25-year-old woman with HIV is diagnosed with Kaposi sarcoma limited to a few cutaneous lesions. CD4 is 180 cells/µL, VL 120,000 copies/mL. She is not yet on ART. What is the initial management?

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Correct answer: C — Start ART — limited cutaneous KS may regress with immune reconstitution alone

For limited cutaneous KS without visceral involvement in a patient not yet on ART, initiation of ART alone may be sufficient. Immune reconstitution from effective ART can lead to regression of KS lesions through restoration of HHV-8-specific immunity. Systemic chemotherapy (liposomal Doxorubicin) is reserved for extensive cutaneous disease, rapid progression, or visceral involvement. The patient should be monitored for KS-IRIS (paradoxical worsening after ART) and for progression that would necessitate chemotherapy.

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