Intralesional Vinblastine KS — SCE Infectious Diseases MCQ

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ModerateHIV MedicineIntralesional Vinblastine KSSCE Infectious Diseases

A 35-year-old man with HIV develops oral Kaposi sarcoma involving the hard palate. He has been on effective ART for 2 years (CD4 380, VL <50). The KS has not regressed despite ART. The lesion is 3 cm, painful, and interfering with eating. What local treatment option can be offered?

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Correct answer: D — Intralesional Vinblastine injection — effective local therapy for symptomatic oral KS lesions

For localised symptomatic oral KS not responding to ART alone, intralesional Vinblastine (0.1 mL of 0.2 mg/mL per cm² of lesion, injected directly) is an effective local treatment. It causes local tumour necrosis and regression. Alternative local treatments include: radiation therapy (for larger or multiple oral lesions), cryotherapy, or laser therapy. Systemic chemotherapy (liposomal Doxorubicin) is added for extensive or rapidly progressive disease despite local measures.

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