Advanced Kaposi Sarcoma — SCE Infectious Diseases MCQ

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ModerateHIV MedicineAdvanced Kaposi SarcomaSCE Infectious Diseases

A 45-year-old man with HIV (CD4 160, VL 85,000) is diagnosed with Kaposi sarcoma involving the lungs (bilateral nodular infiltrates on CT). He has respiratory compromise. What is the chemotherapy of choice for advanced KS?

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Correct answer: C — Liposomal pegylated Doxorubicin (Caelyx)

Liposomal pegylated Doxorubicin (Caelyx/Doxil) is first-line systemic chemotherapy for advanced/visceral AIDS-associated KS. It has superior efficacy and less cardiotoxicity than conventional Doxorubicin. ART must be initiated concurrently. Paclitaxel is second-line. For limited cutaneous disease, ART alone may suffice. Bleomycin-based regimens (ABV — Adriamycin, Bleomycin, Vincristine) are historical and no longer first-line. Response rates with liposomal Doxorubicin plus ART exceed 70%.

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