Kaposi's Sarcoma in HIV Patients, Integrating Cryotherapy and HIV Management: A Case Report

Abstract

Kaposi's sarcoma is a neoplasm associated with human herpesvirus 8 (HHV-8), which commonly affects HIV-positive patients due to their immunosuppression. Since the introduction of combination antiretroviral therapy, its incidence has decreased significantly. This therapy is the cornerstone of treatment, as controlling the HIV viral load reduces immunosuppression, which in turn slows the progression of the sarcoma. In addition, cryotherapy is used for localized skin lesions; this technique employs extreme cold to destroy tumor cells with minimal adverse effects. We present the case of a 52-year-old male patient with a recent HIV diagnosis, who presented with a generalized dermatosis predominantly affecting the facial region, characterized by increased volume in the facial region, concomitant with multiple violaceous lesions. A biopsy was performed and reported findings compatible with Kaposi's sarcoma. PCR for HIV and lymphocyte immunophenotyping were performed: Leukocytes: 3,700/mm3, Lymphocyte count with a CD4/CD8 Index: 0.10. Multidisciplinary treatment was initiated with the infectious disease service for HIV management, which began with combined antiretrovirals Dolutegravil (50mg) / Lamivudine (300mg) / Tenofovir (300mg) (DTL) daily dose and the skin lesions were treated with cryosurgery in 6 sessions with an interval of 15 days, showing evolution at 12 weeks with regression of the lesions in the facial and body region in a satisfactory manner.