Kaposi's Sarcoma in the Immunosuppressed

Abstract

Abstract Kaposi's sarcoma (KS) is a virally induced tumor most commonly appearing in the immunosuppressed. It is caused by infection with human herpesvirus-8, which in healthy individuals causes no symptoms. However, in patients with weakened immune systems, such as in HIV and organ transplant patients, the virus can proliferate leading to KS. Following the introduction of antiretroviral therapy (ART) for HIV and AIDS, the prevalence of AIDS-related KS has fallen, but it has begun to appear in subsets of patients on treatment. Treatments for KS vary depending on the cause of immunosuppression. In the case of HIV, ART is the first-line treatment, but other therapies are initiated based on tumor response. In transplant patients, primary treatment involves stopping or reducing immunosuppression and similarly advancing to other therapies based on response. This presents a dilemma in many cases where chemotherapy will reduce an already-weakened immune system or in strengthening an immune system in patients at risk for transplant rejection. This review will focus on summarizing the effects of immunosuppression in HIV-related (epidemic) and iatrogenically immunosuppressed transplant patients with KS and its etiology, pathophysiology, current treatments, and management along with novel therapies.