IDSA Recommendations for Preventing and Treating HHV-8 Diseases—Kaposi Sarcoma (KS), Primary Effusion Lymphoma (PEL), Multicentric Castleman’s Disease (MCD) in HIV-AIDS Preventing Development of KS: • Since low CD4 cell count and uncontrolled HIV viremia are strong risk factors of KS, early initiation of ART is likely to be the most effective measure for the prevention of KS Mild-to-Moderate KS (localized involvement of skin and/or lymph nodes): • Initiation or optimization of ART Advanced KS (visceral and/or disseminated cutaneous disease): • Chemotherapy (in consultation with specialist) + ART [visceral KS (AI) or widely-disseminated cutaneous KS]. • Liposomal doxorubicin is preferred first-line chemotherapy • Avoid use of corticosteroids in patients with KS, including those with KS-IRIS, given the potential for exacerbation of lifethreatening disease • Antiviral agents with activity against HHV-8 are not recommended for KS treatment PEL: • Chemotherapy (in consultation with a specialist) + ART • Oral valganciclovir or IV ganciclovir can be used as adjunctive therapy #HHV8 #KaposiSarcoma #Castlemans #IDSA #Prevention #Treatment #management #opportunistic #infections #HIVAIDS #pharmacology
