10/12/2007
SF Doctors Surprised and Concerned by Return of Kaposi's Sarcoma
Kaposi's Sarcoma, a type of cancer that makes itself known by unsightly purple lesions which was the very chilling manifestation of the AIDS crisis in the 80's, has returned in a number of patients in San Francisco, worrying scientists, who are concerned about what that might signify.
One told the San Francisco Chronicle, "This could either be the canary in the coal mine, or it could just be a collection of rare events that will continue to occur when people are given what appears to be effective treatment."
The cancer has re-emerged in 15 patients most of whom have had HIV for almost 20 years and are in their 40's and 50's.
Anti-viral drugs virtually vanquished KS in the mid-90's.
Said one patient on whom the lesions have appeared: "I'm of an age to remember when, if a purple lesion showed up on your face, it meant you were going to die. [Finding the lesion] was extremely scary. I got something out of the blue and totally unexpected...I never thought I would have to face this."
Doctors believe that the re-emergence of KS in these patients does not represent the same threat that it did early on in the epidemic but is more of a "nuisance". However, it does worry them that as the immune system ages, it opens the vulnerable up to not only KS, but perhaps a host of other issues as well.
Unsettling re-emergence of 'gay cancer' [sf chronicle]
Sphere: Related ContentPosted 8:25 AM EST by Andy in AIDS/HIV, Health, News, San Francisco | Permalink
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This is scary. I had pretty much forgotten about the Kaposi's Sarcoma lesions until I took a microbiology class last year for nursing school. I'm a non-traditional student, knocking on 40, whereas most of the people in the class are around 19 or 20. It was a weird perspective to be able to discuss the fear these lesions instilled while most of my classmates had never heard of them.
Posted by: Michael W. | Oct 12, 2007 9:17:41 AM
Remember people, fuck safely. HIV treatments are just that, treatments, not a cure. We are roughly 15 years into the "cocktail", we have very little information on long term use of the drugs or how well they will work as a person ages, when one's immune system naturally is not as good as before. Please stay negative.
Posted by: Will | Oct 12, 2007 10:14:28 AM
I wonder if this may be a result of cross-infection. It's just a thought.
I, too, remember how KS frightened so many. Anytime you had a sore or rash people would automatically assume that it was KS. We have to remind everyone that viruses can mutate and that our long battle against HIV-related illnesses is far from over.
Posted by: Gary | Oct 12, 2007 10:25:31 AM
How sad and scared this makes me! "Fuck safely" is right!
Now, will you HIV- barebackers wear a condom, please!
Posted by: Marc | Oct 12, 2007 10:47:59 AM
GARY,
I'm not sure what you mean when you use the term 'cross-infection'. My understanding of that term is when a patient is infected with a second disease through inadequate protections in a health care setting. For example, a patient who is in the hospital for pneaumonia might be cross-infected with tuberculosis if the hospital fails to take precatutions to isolate patients with tuberculosis.
I'm guessing the term you intended to use was 'superinfection' or perhpas 'co-infection'. Co-infection occurs when an HIV negative person is infected with two different strains of HIV at the same time. Superinfection occurs when a person who is already infected with HIV is infected with yet another strain of HIV. See the difference?
I'm not trying to split hairs here...the differences between the terms are important to understand when discussing the re-emergence of KS in these 16 patients. Cross-infection is most certainly NOT the cause of the KS cases that S.F. doctors are seeing since almost all of us already carry the strain of the Human Herpes Virus that causes KS. Likewise, co-infection is also likely not the cause of the KS lesions since most of these patients have been HIV positive for almost 20 years. Were these patients, who already had HIV, infected with a second, different strain of HIV (superinfection) thus causing these cases of KS? Doubtful. There have only been 21 documented cases of superinfection globally (http://www.gladstone.ucsf.edu/gladstone/site/pospart/section/1415). To have a sudden cluster of 16 new superinfections would be strange indeed. Besides, KS lesions usually show up only after the immune system has been ravaged for years. I'm guessing these new KS cases are the result of KS 'breaking through' despite current treatment.
And yeah, the battle is far from over.
peterparker
Posted by: peterparker | Oct 12, 2007 11:14:51 AM
I've been positive for 10 years and with treatment have maintained an undetectable viral load and t-cells of +/-1,000. I've also had two rounds of the KS (treated with chemotherapy) described in the SF Chronicle article. The fact that these Dr's are "surprised" was a big surprise to me and my KS doc - we've been seeing it for years. As the article says, it's easily treated, hasn't progressed and more of a nuisance than anything. More fear mongering?
Posted by: Lumox | Oct 12, 2007 11:29:26 AM
@ LUMOX -- Thanks for sharing this perspective and congratulations on your fight against HIV; I wish you continued success!
It is interesting to note that you and your doctor have been seeing KS -- I suspect that it is one of things that never went away, but, in the face of triumphalist, post-cocktail media coverage, it lost its place in the public consciousness.
I would argue, however, with a suspicion that this is fear mongering.
First, while I would not advocate a society of permanent dread, I do think that early warning of emerging (even suspected emerging) mutations/implications/whateverations of HIV are important. Frankly, it is one of the best practices we learned back in the mid-eighties -- communicating the emerging trend helped mobilize some in the healthcare and gay communities to begin to investigate, isolate and eventually treat HIV.
Second, with all respect, what you may see as a nuisance, others may see as a debilitating (physically and/or psychically) symptom...and I do not know what kind of chemotherapy you had to endure (twice) but, again, some might see that as terrifying versus a nuisance. In which case, to spare one more HIV sero-conversion, I am glad this news is finally out and I hope it receives the appropriate level of attention.
Thanks again for taking the time to share your \\\\\"insider view!\\\\\"
Posted by: Becks07 | Oct 12, 2007 11:50:27 AM
We can use some "fear mongering" right now. Have you recently been online? The sheer number of people who proudly advertise they are only looking for "BB" is astounding and so is the number of those who describe themselves as "negative." GIve me a break!
Posted by: ReasonBased | Oct 12, 2007 12:15:46 PM
Re: BECKS07, Thanks! I completely agree with you regarding sparing additional HIV sero-conversion. However, for those that are already positive it's not something to get yourself worked up over.
Posted by: LUMOX | Oct 12, 2007 12:17:52 PM
Holy shit.
Posted by: thin mint | Oct 12, 2007 2:46:22 PM
Holy shit.
Posted by: thin mint | Oct 12, 2007 2:47:16 PM
Holy shit.
Posted by: thin mint | Oct 12, 2007 2:47:29 PM
Holy shit.
Posted by: thin mint | Oct 12, 2007 2:47:44 PM
I hope this isn’t more fear mongering buy some high priced pharmaceutical company with a half-assed treatment. The problem with newspapers and all media is they will print press releases from pharma companies and their PR firms and call it news. Remember a few months ago that HPV was going to kill us all? (Until the vaccine proved ineffectual to those over 12 then not so much)
Posted by: ggreen | Oct 12, 2007 3:42:17 PM
I don't object to a little fear mongering if it is to encourage people to use condoms.
However, Merck is coming out with a new pill for those who are hard to treat infections.
http://hosted.ap.org/dynamic/stories/H/HIV_DRUG?SITE=ALOPE&SECTION=HOME&TEMPLATE=DEFAULT
Posted by: Wheezy | Oct 13, 2007 3:44:20 AM
Sorry, I meant to say people who HAVE hard to treat infections. My bad.
Posted by: Wheezy | Oct 13, 2007 3:45:34 AM