[spiveker]

Source: San Francisco Chronicle

San Francisco doctors have reported a cluster among gay men of unusual cases of Kaposi's sarcoma, the cancer-like skin disease whose disfiguring purple lesions were a terrifying signature of a bygone era of the AIDS epidemic.

All 15 patients under treatment for the condition are long-term survivors of HIV whose infections are firmly under control with antiviral drugs. So far, none of them appears to be in any danger.

The new cases of Kaposi's sarcoma have not been aggressive, invasive or lethal - the way the disease behaved in patients with uncontrolled HIV during the 1980s.

Still, the lesions are unsightly, difficult to treat and raise uncomfortable questions about what weaknesses might lurk in the immune systems of thousands of aging survivors of the epidemic.

The re-emergence of this classic AIDS illness in these outwardly healthy patients is an unsettling echo from the past and a warning that this 26-year-old plague still has the capacity to surprise.

Read more: http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/1...

[Aozenee]

^BrooklynRider's correct link

Doctors See Return of Kaposi's Sarcoma in Handful of AIDS Patients
The skin cancer, which causes lesions, can be controlled with newer treatments

WEDNESDAY, Sept. 26 (HealthDay News) -- San Francisco doctors say they've seen a small number of longtime HIV patients with mild cases of Kaposi's sarcoma, a potentially dangerous condition that once plagued people with AIDS.

It's not clear why Kaposi's sarcoma is making a comeback, or whether it may pose a significant health threat to AIDS patients. Still, it's unusual that the condition is appearing in people who have largely controlled the AIDS virus in their bodies, said report lead author Dr. Toby Maurer, associate professor of dermatology at the University of California, San Francisco.

Kaposi's sarcoma, a type of skin cancer that causes disfiguring lesions, was largely limited to Mediterranean men before the AIDS epidemic. When the epidemic began in the United States, many gay men with AIDS developed the condition, apparently because their bodies already harbored the virus that causes it, Maurer said.

Kaposi's sarcoma stigmatized AIDS patients by causing lesions on their faces, and some people died. But a new generation of AIDS drugs released in the late 1990s helped patients strengthen their immune systems and kept Kaposi's sarcoma at bay, at least in the Western world.

The condition remains common in Africa, where it affects both men and women, Maurer said.

The condition hasn't disappeared entirely in the United States, however, and is still seen in AIDS patients who don't take antiretroviral drugs.

In a new report, published in a letter to the editor in the Sept. 27 issue of the New England Journal of Medicine, Maurer and his colleagues said they've seen an "unusual" cluster of nine cases of Kaposi's sarcoma in patients who have their HIV infection under control.

The patients, who were diagnosed with Kaposi's sarcoma between 2004 and 2006, had been HIV-positive for an average of 18 years and had taken antiretroviral AIDS drugs for an average of seven years. The average age of the patients was 51.

"They've been doing well for a long period of time, and they have Kaposi's sarcoma," Maurer said. "We're curious as to what this means. Is something going on with their immune systems after years of HIV and drug therapy? It's a reminder of how HIV presented 25 years ago, and it brings up a lot of questions and worries."

Fortunately, the new cases of Kaposi's sarcoma are not severe, although they do begin with lesions, Maurer said. Doctors can use a variety of treatments, including injections and a topical gel, to treat the condition.

Dr. David Aboulafia, attending hematologist and oncologist at Virginia Mason Clinic in Seattle, said AIDS patients should know that Kaposi's sarcoma remains very rare, especially when compared to the early days of the AIDS epidemic, when it struck about one-third of patients. And the treatments available today are effective and fairly easy for people to tolerate, he said.