{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:41:52Z","timestamp":1777927312696,"version":"3.51.4"},"reference-count":67,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2020,6,3]],"date-time":"2020-06-03T00:00:00Z","timestamp":1591142400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:p>In areas of high HIV and human herpes virus 8 prevalence, life-threatening forms of Kaposi sarcoma (KS) can occur in HIV-positive women during pregnancy. Treating KS in pregnancy must balance both the well-being of the mother with the health of the fetus, yet data and recommendations on the best treatment approach for KS during pregnancy are limited. Without effective treatment, which can be difficult to obtain in low income countries (LICs), the mother and infant are at risk for poor outcomes. A successful case report is used as teaching example, followed by a detailed review of the literature that culminates in recommendations for treating KS during pregnancy among HIV-positive women in LICs. A 31-year-old HIV-positive woman presented for care in April 2016 at 28\u2009weeks gestation with extensive KS skin lesions, KS lymphadenopathy, and a large oropharynx KS lesion causing partial airway obstruction. She had initiated antiretroviral therapy (ART) months prior and was virally suppressed, suggesting KS-immune reconstitution inflammatory syndrome. Due to the severity of KS and her third trimester status, combination chemotherapy was initiated using bleomycin, vincristine, and doxorubicin followed by maintenance therapy with paclitaxel. She showed remarkable response to the chemotherapy and had a normal vaginal delivery of a healthy baby at full term. Full clinical remission was achieved, and her baby was HIV-negative with no negative health effects of the KS or the chemotherapy. Review of the sparse existing literature demonstrates the importance, safety, and effectiveness of treating KS during pregnancy. We offer simple adaptable treatment recommendations for use in treating HIV-positive women with KS during pregnancy in LICs. Life-threatening KS can be treated using chemotherapy and ART in resource-limited settings, allowing for good outcomes in mother and infant. While monotherapy with liposomal doxorubicin or paclitaxel is preferred, these are often not available in LICs. As alternatives, bleomycin, vincristine, and doxorubicin can be safely used during the second and\/or third trimesters for treating KS. Following a simple treatment approach can be an effective way to treat KS in pregnancy for pregnant women living with HIV in an LIC setting.<\/jats:p>","DOI":"10.1177\/0956462420920160","type":"journal-article","created":{"date-parts":[[2020,6,4]],"date-time":"2020-06-04T00:59:51Z","timestamp":1591232391000},"page":"724-734","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Recommendations for treating life-threatening Kaposi sarcoma  during pregnancy in HIV-positive  women in low income countries"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1093-5227","authenticated-orcid":false,"given":"Jason M","family":"Bacha","sequence":"first","affiliation":[{"name":"Baylor College of Medicine Children\u2019s Foundation \u2013 Tanzania, Mbeya, Tanzania"},{"name":"Baylor International Pediatric AIDS Initiative (BIPAI) at Texas Children\u2019s Hospital, Baylor College of Medicine, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nader K","family":"El-Mallawany","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine \u2013 Texas Children\u2019s Cancer and Hematology Centers, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy S","family":"Slone","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine \u2013 Texas Children\u2019s Cancer and Hematology Centers, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey P","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine, Department of Obstetrics and Gynecology, Global Women\u2019s Health, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parth S","family":"Mehta","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine \u2013 Texas Children\u2019s Cancer and Hematology Centers, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liane R","family":"Campbell","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Children\u2019s Foundation \u2013 Tanzania, Mbeya, Tanzania"},{"name":"Baylor International Pediatric AIDS Initiative (BIPAI) at Texas Children\u2019s Hospital, Baylor College of Medicine, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,6,3]]},"reference":[{"key":"bibr1-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000071"},{"key":"bibr2-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000329"},{"key":"bibr3-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1093\/jpids\/pit051"},{"key":"bibr4-0956462420920160","first-page":"602","volume":"96","author":"Sebitloane HM","year":"2006","journal-title":"S Afr Med J"},{"key":"bibr5-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00791-06"},{"key":"bibr6-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1055\/s-2004-831880"},{"key":"bibr7-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-015-1348-9"},{"key":"bibr8-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0013936"},{"key":"bibr9-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1177\/0956462414544724"},{"key":"bibr10-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61152-X"},{"key":"bibr11-0956462420920160","doi-asserted-by":"publisher","DOI":"10.4172\/1948-5956.1000145"},{"key":"bibr12-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1136\/esmoopen-2017-000285"},{"key":"bibr13-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1038\/nrc2372"},{"key":"bibr14-0956462420920160","unstructured":"James S. Meeting the challenge of cancer care in Northern Tanzania \u2013 a program for comprehensive and sustainable care. The Foundation for Cancer Care in Tanzania, 2015."},{"key":"bibr15-0956462420920160","volume-title":"World Health Organization cancer country profiles \u2013 United Republic of Tanzania","author":"WHO","year":"2014"},{"key":"bibr16-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2014.32.15_suppl.e20607"},{"key":"bibr17-0956462420920160","first-page":"354","volume":"19","author":"Basta P","year":"2015","journal-title":"Contemp Oncol"},{"key":"bibr18-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000004899"},{"key":"bibr19-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1016\/j.jare.2016.01.004"},{"key":"bibr20-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1159\/000349987"},{"key":"bibr21-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-200306000-00002"},{"key":"bibr22-0956462420920160","first-page":"330","volume":"41","author":"McCarty KA","year":"1995","journal-title":"Cent Afr J Med"},{"key":"bibr23-0956462420920160","first-page":"1134","volume":"2","author":"Ngwenya S.","year":"2016","journal-title":"Open J Clin Med Rep"},{"key":"bibr24-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1093\/jncimonographs\/lgi009"},{"key":"bibr25-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1016\/j.canlet.2011.02.006"},{"key":"bibr26-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1007\/s40257-017-0270-4"},{"key":"bibr27-0956462420920160","first-page":"204","volume":"5","author":"Azim H","year":"2011","journal-title":"Ecancermedicalscience"},{"key":"bibr28-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1136\/esmoopen-2015-000016"},{"key":"bibr29-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdt199"},{"key":"bibr30-0956462420920160","doi-asserted-by":"crossref","first-page":"378","DOI":"10.12891\/ceog1706.2015","volume":"42","author":"Mian DB","year":"2015","journal-title":"Clin Exp Obstet Gynecol"},{"key":"bibr31-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1258\/ijsa.2012.012141"},{"issue":"3","key":"bibr32-0956462420920160","first-page":"2S","volume":"63","author":"Rawlinson KF","year":"1984","journal-title":"Obstet Gynecol"},{"key":"bibr33-0956462420920160","unstructured":"Cancer.Net Editorial Board. Cancer during pregnancy. Cancer.net Articles 2012, https:\/\/www.cancer.net\/navigating-cancer-care\/dating-sex-and-reproduction\/cancer-during-pregnancy (accessed 4 April 2019)."},{"key":"bibr34-0956462420920160","first-page":"278","volume":"2","author":"Van Calsteren K.","year":"2010","journal-title":"Facts Views Vis Obgyn"},{"key":"bibr35-0956462420920160","first-page":"1","volume":"4","author":"El-Mallawany NK","year":"2018","journal-title":"J Glob Oncol"},{"key":"bibr36-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1111\/jmwh.12611"},{"key":"bibr37-0956462420920160","first-page":"258","volume":"10","author":"Amant F.","year":"2012","journal-title":"Clin Adv Hematol Oncol"},{"key":"bibr38-0956462420920160","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2014.00065"},{"key":"bibr39-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1124\/dmd.112.050245"},{"key":"bibr40-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1007\/BF00258112"},{"key":"bibr41-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1007\/s12262-009-0098-0"},{"key":"bibr42-0956462420920160","doi-asserted-by":"publisher","DOI":"10.2174\/138920111795470877"},{"key":"bibr43-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0b013e318236e9f9"},{"key":"bibr44-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1517\/14740338.2015.1061500"},{"key":"bibr45-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2015.10.007"},{"key":"bibr46-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1097\/CCO.0000000000000386"},{"key":"bibr47-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1508913"},{"key":"bibr48-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1097\/COC.0b013e3181a44ca9"},{"key":"bibr49-0956462420920160","volume":"308","author":"Kalter H","year":"1983","journal-title":"N Engl J Med"},{"key":"bibr50-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2009.11.007"},{"key":"bibr51-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8545(05)70007-3"},{"key":"bibr52-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1159\/000151759"},{"key":"bibr53-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.62.4445"},{"key":"bibr54-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(11)70363-1"},{"key":"bibr55-0956462420920160","first-page":"74","volume":"2","author":"Vandenbriele C","year":"2010","journal-title":"Facts Views Vis Obgyn"},{"key":"bibr56-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1258\/om.2009.090007"},{"key":"bibr57-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1007\/s00280-014-2406-z"},{"key":"bibr58-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(17)30091-3"},{"key":"bibr59-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2012.10.002"},{"key":"bibr60-0956462420920160","unstructured":"Children\u2019s Oncology Group. Drug information for commercial agents used by the Children\u2019s Oncology Group. 12 April 2010, version number 4, https:\/\/members.childrensoncologygroup.org\/prot\/reference_materials.asp (accessed 12 April 2019)."},{"key":"bibr61-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4757-4242-8_7"},{"key":"bibr62-0956462420920160","volume-title":"The optimal duration of exclusive breastfeeding: report of the expert consultation","author":"World Health Organization","year":"2001"},{"key":"bibr63-0956462420920160","volume-title":"Complementary feeding: report of the global consultation \u2013 summary of guiding principles","author":"World Health Organization","year":"2003"},{"key":"bibr64-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1038\/s41372-018-0068-0"},{"key":"bibr65-0956462420920160","first-page":"CD003256","volume":"9","author":"Gbabe OF","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr66-0956462420920160","doi-asserted-by":"publisher","DOI":"10.1097\/CCO.0b013e328349428d"},{"key":"bibr67-0956462420920160","doi-asserted-by":"publisher","DOI":"10.2147\/PHMT.S142816"}],"container-title":["International Journal of STD &amp; AIDS"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0956462420920160","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0956462420920160","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0956462420920160","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:40:38Z","timestamp":1777675238000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0956462420920160"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,3]]},"references-count":67,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2020,7]]}},"alternative-id":["10.1177\/0956462420920160"],"URL":"https:\/\/doi.org\/10.1177\/0956462420920160","relation":{},"ISSN":["0956-4624","1758-1052"],"issn-type":[{"value":"0956-4624","type":"print"},{"value":"1758-1052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,3]]}}}