The role of immune restoration using highly active antiretroviral therapy in the management of AIDS-related Kaposi's sarcoma coexisting with pulmonary tuberculosis

Niger Postgrad Med J. 2020 Jan-Mar;27(1):63-66. doi: 10.4103/npmj.npmj_102_19.

Abstract

A 35-year-old highly active antiretroviral therapy (HAART)-naïve woman diagnosed 2 years earlier presented with complaints of cough, fever and progressive weight loss of 5 months and skin rashes of 2 months. Clinical examination revealed a chronically ill-looking young woman who was wasted and pale, with purplish flat-topped papules and nodules on the skin of her neck, trunk, forearms and thighs. She also had a single lesion on the hard palate. Chest examination shows reduced breath sounds with crepitations. Sputum acid-fast bacilli were positive, and skin biopsy taken for histology confirmed Kaposi's sarcoma (KS). The patient recovered fully on antiretroviral and antituberculosis therapy without the need for any specific chemotherapy for KS. We report this case to elucidate the role of immune reconstitution as a treatment modality for AIDS-related KS, as well as to point out the possibility of multiple opportunistic conditions coexisting amongst patients with advanced HIV disease.

Keywords: AIDS-related Kaposi's sarcoma; Advanced HIV disease; highly active antiretroviral therapy naïve; multiple opportunistic conditions; non-nucleoside reverse transcriptase inhibitor-based regimens; tuberculosis.

Publication types

  • Case Reports

MeSH terms

  • Acquired Immunodeficiency Syndrome* / complications
  • Acquired Immunodeficiency Syndrome* / drug therapy
  • Adult
  • Antiretroviral Therapy, Highly Active*
  • Female
  • Humans
  • Immune Reconstitution*
  • Nigeria
  • Sarcoma, Kaposi* / drug therapy
  • Sarcoma, Kaposi* / etiology
  • Tuberculosis, Pulmonary* / complications