Sarcoma de Kaposi asociado a VIH: Uso de doxorrubina loposomal terapia antirretroviral de alta eficicencia

at present there are no defined criteria for treating kaposi′s sarcoma associated with hiv in the era of highly active antiretroviral therapy. evidence of regression of cutaneous lesions with only retroviral high efficacy therapy without need of chemotherapy; nevertheless, it is very unlikely that visceral or mucous lesions respond to retroviral without simultaneous initiation chemotherapy. objective: prospective study in ？low risk？ and ？high risk？ kaposi patients, trying to define the adequate moment for initiating the chemotherapy simultaneously with retroviral. method: 66 male kaposi patients, 28(42 %) t0i0s0, 6 (9 %) t0i0s1, 8 (12 %) t0i1s1, 5 (8 %) t1i1s0 y 19 (29 %) t1i1s1. all t1, t0i1s1 and a third of t0i0s1 patients were treated with chemotherapy (4 to 8 cycles with liposomal doxorubicin) but none of the t0i0s0 patients. results: 34 clinical responses, 6 (18) complete (3 t1i1s1, 2 t1i1s0, and 1 t0i1s1), 23 (68 %) partial (16 t1i1s1, 3 t1i1s0, 3 t0i1s1, and 1 t0i0s1) and 5 (14 %) stable disease (t0i1s1). conclusions: all patients with extensive tumors require chemotherapy administration since the moment of diagnosis, together with retroviral high efficacy agents. patients with localized tumors, cd4 cell levels ≤ 200 /μl), and systemic symptoms will require chemotherapy in approximately 2 to 3 months period after initiation of retroviral, while none of patients with localized tumors, without systemic symptoms, and cd4 cell levels > 200 /μl will require chemotherapy, at least in a mean 20 months follow-up period.