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Author Topic: New Research Gives Insights on Karposi Sarcoma Risk  (Read 3453 times)

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Offline Ptrk3

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New Research Gives Insights on Karposi Sarcoma Risk
« on: July 21, 2017, 11:06:32 am »
From the July 19, 2017, edition of BETA:

Summary:

People who had low recent CD4 counts, high recent viral loads, or who had higher average viral loads over time had the highest risk of developing Kaposi sarcoma, according to a study published this month in JAIDS. By analyzing medical data from thousands of people living with HIV across many years, a team of researchers were able to develop a mathematical model of factors independently associated with Kaposi sarcoma (KS, an opportunistic cancer characteristic of AIDS).

Link to full article:

http://betablog.org/whos-risk-getting-kaposi-sarcoma/

More study is needed, according to the article.
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Offline Jim Allen

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Re: New Research Gives Insights on Karposi Sarcoma Risk
« Reply #1 on: July 21, 2017, 12:53:04 pm »
Thanks.

Very interesting, and at the same time shocking, it should not be but somehow it is.
The cumulative viral load finding, is interesting idea and measurement, wonder if we will perhaps see that in the study of other cancer outcomes.

Jim

Quote
They found that a person’s most recent CD4 count, their most recent viral load count, and a cumulative measure of viral load over time were independent risk factors for developing KS. Previous research has identified associations between CD4 count, viral load and KS risk, but this is one of the only studies to make conclusions about risk based on a comprehensive examination of both recent and cumulative measures and a relatively large sample size.

The researchers included data from 77,696 people from the U.S. and Canada in the North American AIDS Cohort Collaboration on Research and Design, who were followed between 1996 and 2009. The majority of people in the study were male (85%).

People with recent CD4 counts less than 50 cells/uL were 12 times more likely to develop KS than people with CD4 counts equal to or over 500. People with recent viral loads over 100,000 copies/mL were about four times more likely to develop KS than people with viral loads less than or equal to 500 copies/mL. People with an average viral load over 100,000 copies/mL were two and a half times more likely to develop KS than people with an average viral load less than 500 copies/mL.


“The most interesting—and most novel—finding from the study was the cumulative viral load finding,” said lead author Robert Dubrow, MD, PhD. “This isn’t something that’s been found before. For people living with HIV—and in terms of patient care—it speaks to the importance of people starting HIV treatment right away.

This minimizes the amount of time they spend with an elevated viral load and therefore, our results indicate, should decrease their risk of KS.”
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Offline Almost2late

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Re: New Research Gives Insights on Karposi Sarcoma Risk
« Reply #2 on: July 21, 2017, 01:26:15 pm »
I had assumed that this was already established, I thought this was an aids thing.. what am I not understanding?

Offline paintedroom

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Re: New Research Gives Insights on Karposi Sarcoma Risk
« Reply #3 on: July 21, 2017, 01:37:49 pm »
My nadir was 50 with a VL 50000 - i had 2 KS lesions,one on my neck and one on the back of my calf.Couldn`t find where the one on my neck was and the one on the back of my calf is almost nothing now..that`s 12 months from DX.
Still strange to conceive of myself as that man on paper.

 i had read somewhere that KS was strongly indicated by popper use ?
Dx`d mid July 2016
8/8/2016 - CD4 50     VL 50,000
5/9/2016 -  CD4 150
13/9/2016  VL  undetectable.
March `17 - CD4 193   VL undetectable.
March  `18 CD4 214    VL undetectable
March 2019 CD4 325  VL UD
Genvoya - Changed to Biktarvy feb 2021

Offline Ptrk3

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Re: New Research Gives Insights on Karposi Sarcoma Risk
« Reply #4 on: July 21, 2017, 01:41:16 pm »
Here's the novel "take away:"

“The most interesting—and most novel—finding from the study was the cumulative viral load finding,” said lead author Robert Dubrow, MD, PhD. “This isn’t something that’s been found before. For people living with HIV—and in terms of patient care—it speaks to the importance of people starting HIV treatment right away. This minimizes the amount of time they spend with an elevated viral load and therefore, our results indicate, should decrease their risk of KS.”

******

To me, this means that even if someone achieves viral suppression and decent CD4 recovery, the length of time with high viral loads/low CD4's before achieving viral suppression/CD4 recovery increases the (statistical) likelihood of developing karposi sarcoma even after viral suppression/CD4 recovery.

In other words, the study once again confirms that is best to start an antiretroviral  regimen immediately upon diagnosis, regardless of viral load or CD4 numbers.
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Offline Almost2late

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Re: New Research Gives Insights on Karposi Sarcoma Risk
« Reply #5 on: July 21, 2017, 02:17:10 pm »
Here's the novel "take away:"

“The most interesting—and most novel—finding from the study was the cumulative viral load finding,” said lead author Robert Dubrow, MD, PhD. “This isn’t something that’s been found before. For people living with HIV—and in terms of patient care—it speaks to the importance of people starting HIV treatment right away. This minimizes the amount of time they spend with an elevated viral load and therefore, our results indicate, should decrease their risk of KS.”

******

To me, this means that even if someone achieves viral suppression and decent CD4 recovery, the length of time with high viral loads/low CD4's before achieving viral suppression/CD4 recovery increases the (statistical) likelihood of developing karposi sarcoma even after viral suppression/CD4 recovery.

In other words, the study once again confirms that is best to start an antiretroviral  regimen immediately upon diagnosis, regardless of viral load or CD4 numbers.

Thanks for clearing  it up for me..
My ks disappeared with meds very quickly so I assumed it was the same for most people once on treatment.. I also heard of people higher cd4s getting it too but never heard of people getting it after treatment had suppressed the vl.


Offline Ptrk3

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Re: New Research Gives Insights on Karposi Sarcoma Risk
« Reply #6 on: July 21, 2017, 02:28:48 pm »
I have not heard of that either (developing KS after viral suppression/CD4 recovery).   

Here's a link to the study's abstract:

http://journals.lww.com/jaids/Citation/2017/08010/Association_of_CD4__T_cell_Count,_HIV_1_RNA_Viral.2.aspx

From the abstract:

Conclusions: Our results suggested a multifactorial etiology for KS, with early and late phases of development. The cumulative VL effect suggested that controlling HIV replication promptly after HIV diagnosis is important for KS prevention. We observed no evidence for direct anti-KS activity of ART, independent of CD4 count and VL.

*****

I presume this means that the study found no evidence that ART, in itself, reduces the risk of KS in some people with HIV.  Of course, since there is a "multifactorial etiology" for KS development, more study may be needed to firmly make that conclusion.

But it is clear that the study supports the initiation of antiretroviral therapy immediately upon diagnosis.
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Offline harleymc

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Re: New Research Gives Insights on Karposi Sarcoma Risk
« Reply #7 on: August 23, 2017, 07:55:26 pm »
Paintedroom, that myth about popper use was a hypothesis that existed before HIV, and later the virus KSHV that interacts with HIV to cause KS, were discovered.

Kaposi sarcoma (KS) is caused by infection with a virus called the Kaposi sarcoma associated herpesvirus (KSHV), also known as human herpesvirus 8 (HHV8). KSHV is in the same family as Epstein-Barr virus (EBV), the virus that causes infectious mononucleosis (mono) and is linked to several types of cancer.
https://www.cancer.org/cancer/kaposi-sarcoma/causes-risks-prevention/what-causes.html

Offline paintedroom

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Re: New Research Gives Insights on Karposi Sarcoma Risk
« Reply #8 on: August 24, 2017, 02:33:39 am »
Thanks for clearing that up harley.
Dx`d mid July 2016
8/8/2016 - CD4 50     VL 50,000
5/9/2016 -  CD4 150
13/9/2016  VL  undetectable.
March `17 - CD4 193   VL undetectable.
March  `18 CD4 214    VL undetectable
March 2019 CD4 325  VL UD
Genvoya - Changed to Biktarvy feb 2021

 


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