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KS Complete Regression on ART — SCE Infectious Diseases MCQ

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EasyHIV MedicineKS Complete Regression on ARTSCE Infectious Diseases

A 30-year-old woman with HIV develops Kaposi sarcoma limited to 3 small cutaneous lesions on her lower legs. She has just started ART (CD4 150, VL 180,000). She is otherwise well. After 3 months on ART, her VL drops to <50 and CD4 rises to 280. The KS lesions have COMPLETELY regressed. What maintenance therapy is needed for KS?

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Correct answer: D — No specific KS maintenance therapy — continue ART; ART-induced immune reconstitution has caused complete KS regression; monitor for recurrence clinically

Limited cutaneous KS that completely regresses with ART alone does NOT require ongoing KS-specific therapy. Continued ART maintains HHV-8-specific immunity. Clinical monitoring (skin examination at regular HIV clinic visits) is sufficient. Recurrence of KS on ART can occur and should prompt re-assessment of viral suppression, CD4 count, and consideration of systemic chemotherapy if KS progresses. The key message: ART is the most important long-term 'treatment' for HIV-associated KS.

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