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Titolo:
Virologic and immunologic parameters that predict clinical response of AIDS-associated Kaposi's sarcoma to highly active antiretroviral therapy
Autore:
Pellet, C; Chevret, S; Blum, L; Gauville, C; Hurault, M; Blanchard, G; Agbalika, F; Lascoux, C; Ponscarme, D; Morel, P; Calvo, F; Lebbe, C;
Indirizzi:
Hop St Louis, Dept Dermatol, F-75010 Paris, France Hop St Louis Paris France F-75010 , Dept Dermatol, F-75010 Paris, France Hop St Louis, Pharmacol Lab, F-75010 Paris, France Hop St Louis Paris France F-75010 , Pharmacol Lab, F-75010 Paris, France Hop St Louis, Dept Biostat, F-75010 Paris, France Hop St Louis Paris France F-75010 s, Dept Biostat, F-75010 Paris, France Hop St Louis, Microbiol Lab, Virol Unit, F-75010 Paris, France Hop St Louis Paris France F-75010 Lab, Virol Unit, F-75010 Paris, France Hop St Louis, Dept Internal Med, F-75010 Paris, France Hop St Louis Paris France F-75010 pt Internal Med, F-75010 Paris, France Hop St Louis, Dept Infect Dis, F-75010 Paris, France Hop St Louis Paris France F-75010 Dept Infect Dis, F-75010 Paris, France Ctr Hosp Rene Dubos, Dept Med, Pontoise, France Ctr Hosp Rene Dubos Pontoise France e Dubos, Dept Med, Pontoise, France Ctr Hosp Rene Dubos, Virol Lab, Pontoise, France Ctr Hosp Rene Dubos Pontoise France Dubos, Virol Lab, Pontoise, France
Titolo Testata:
JOURNAL OF INVESTIGATIVE DERMATOLOGY
fascicolo: 4, volume: 117, anno: 2001,
pagine: 858 - 863
SICI:
0022-202X(200110)117:4<858:VAIPTP>2.0.ZU;2-C
Fonte:
ISI
Lingua:
ENG
Soggetto:
HUMAN-HERPESVIRUS-8 VIRAL LOAD; HERPESVIRUS; INFECTION; CELLS; COHORT; TIME; SEROCONVERSION; SURVIVAL; FAILURE; DISEASE;
Keywords:
highly active antiretroviral therapy; Kaposi's sarcoma; KSHV viral load; predictive factors;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
31
Recensione:
Indirizzi per estratti:
Indirizzo: Lebbe, C Hop St Louis, Dept Dermatol, 1 Ave Claude Vellefaux, F-75010 Paris, France Hop St Louis 1 Ave Claude Vellefaux Paris France F-75010 France
Citazione:
C. Pellet et al., "Virologic and immunologic parameters that predict clinical response of AIDS-associated Kaposi's sarcoma to highly active antiretroviral therapy", J INVES DER, 117(4), 2001, pp. 858-863

Abstract

The purpose of the work was to assess the predictive value of biologic factors on the efficacy of highly active antiretroviral therapy alone or combined with chemotherapy on AIDS-associated Kaposi's sarcoma. Twenty-six AIDS-Kaposi's sarcoma patients who started therapy with protease inhibitors wereinvestigated. No baseline chemotherapy was associated with less severe initial clinical status. Median followup was 652 d. The main outcome measures were as follows: best Kaposi's sarcoma clinical response; Kaposi's-sarcoma-associated herpesviral load in peripheral blood mononuclear cells using real-time quantitative polymerase chain reaction (non-detectable if less than 100 copies per tg); human immunodeficiency viral charge in plasma (non-detectable if less than 200 copies per ml); and CD4 lymphocyte count. Time to undetectable Kaposi's-sarcoma-associated herpesviral load, time to undetectable human immunodeficiency viral charge, and time to CD4 greater than or equal to 150 per mul were also recorded over time, from 2 mo measurements. Patients were staged according to the AIDS Clinical Trials Group-based tumor,immune, systemic staging system criteria. At baseline, Kaposi's sarcoma was progressive for 25 (96%) of the 26 enrolled patients. Complete or partialresponse to highly active antiretroviral therapy alone or combined with chemotherapy was achieved in 22 patients (85%). Median time to clinical response was estimated at 251 d. Clinical response was faster in patients without chemotherapy at baseline (p = 0.003) as well as in patients not previously treated with reverse transcriptase inhibitors (p = 0.0012). Using univariable analyses, predictive factors of clinical response were undetectable Kaposi's-sarcoma-associated herpesviremia (p = 0.013), undetectable human immunodeficiency viremia (p = 0.03), and relative variation of CD4 lymphocytes(p = 0.004). Using multivariable analysis, undetectable Kaposi's-sarcoma-associated herpesviremia (p = 0.009) and relative variation of CD4 (p = 0.005) were independently selected as having a predictive value for clinical response. Occurrence of nondetection of either Kaposi's-sarcoma-associated herpesvirus or human immunodeficiency virus was not associated with baseline CD4 value. Kaposi's-sarcoma-associated herpesvirus quantitative viral charge is an independent predictive factor of the efficacy of highly active antiretroviral therapy on AIDS-Kaposi's sarcoma. Our results support immune reconstitution as a mechanism of response of Kaposi's sarcoma to highly activeantiretroviral therapy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/12/20 alle ore 18:07:09