An Unusual Cluster of HIV-Associated Kaposi Sarcoma?

HIV-associated Kaposi sarcoma (KS) typically occurs in patients who have low CD4 counts (<150 cells/mm³) and high viral loads (>10,000 copies/mL). In most patients, KS lesions regress within the first year of antiretroviral therapy (ART), as immune function improves and viral load declines. However, investigators in San Francisco recently reported an unusual cluster of nine patients who developed HIV-associated KS despite good immune function.

At the time of KS diagnosis, patients were aged 41 to 74 (median, 51) and had been infected with HIV for 4 to 25 years (median, 18 years). None had a history of opportunistic infections. All were receiving maximal ART and had sustained CD4 counts >300 cells/mm³ and undetectable viral loads for at least…