{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:44:37Z","timestamp":1792190677886,"version":"4.4.0"},"reference-count":125,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T00:00:00Z","timestamp":1644969600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>People living with HIV (PLWH) with advanced immunosuppression who initiate antiretroviral therapy (ART) are susceptible to the occurrence of an immune reconstitution inflammatory syndrome (IRIS). Although ART is responsible for AIDS- associated Kaposi sarcoma (KS) improvement and resolution, new onset (unmasking KS-IRIS) or sudden progression of preexisting KS (paradoxical KS-IRIS) can occur after a time delay of between a few days and 6 months after the initiation or resumption of ART, even in patients with a low degree of immunocompromise. KS-IRIS incidence varies from 2.4% to 39%, depending on study design, populations, and geographic regions. Risk factors for developing KS-IRIS include advanced KS tumor stage (T1), pre-treatment HIV viral load &gt;5 log10 copies\/mL, detectable pre-treatment plasma-KSHV, and initiation of ART alone without concurrent chemotherapy. Both paradoxical and unmasking KS-IRIS have been associated with significant morbidity and mortality, and thrombocytopenia (&lt;100,000 platelets\/mm3 at 12 weeks) has been associated with death. KS-IRIS is not to be considered as ART failure, and an ART regimen must be pursued. Systemic chemotherapy for KS in conjunction with ART is recommended and, in contrast with management of IRIS for other opportunistic infections, glucocorticoids are contra-indicated. Despite our preliminary results, the place of targeted therapies in the prevention or treatment of KS-IRIS needs further assessment.<\/jats:p>","DOI":"10.3390\/cancers14040986","type":"journal-article","created":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T20:26:41Z","timestamp":1645043201000},"page":"986","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Immune Reconstitution Inflammatory Syndrome Associated Kaposi Sarcoma"],"prefix":"10.3390","volume":"14","author":[{"given":"Isabelle","family":"Poizot-Martin","sequence":"first","affiliation":[{"name":"Assistance Publique-H\u00f4pitaux de Marseille (APHM), Inserm, Institut de Recherche pour le D\u00e9veloppement (IRD), SESSTIM, Sciences Economiques & Sociales de la Sant\u00e9 & Traitement de l\u2019Information M\u00e9dicale, ISSPAM, APHM Sainte-Marguerite, Service D\u2019immuno-H\u00e9matologie Clinique, Aix-Marseille Universit\u00e9, 13009 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2735-7793","authenticated-orcid":false,"given":"Sylvie","family":"Br\u00e9gigeon","sequence":"additional","affiliation":[{"name":"Assistance Publique-H\u00f4pitaux de Marseille (APHM) Sainte-Marguerite, Service D\u2019immuno-H\u00e9matologie Clinique, Aix-Marseille Universit\u00e9, 13009 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0047-0101","authenticated-orcid":false,"given":"Romain","family":"Palich","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Piti\u00e9-Salp\u00eatri\u00e8re Hospital, Assistance Publique-H\u00f4pitaux de Paris (APHP), Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM U1136, Sorbonne University, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4808-8999","authenticated-orcid":false,"given":"Anne-Genevi\u00e8ve","family":"Marcelin","sequence":"additional","affiliation":[{"name":"INSERM, Institut Pierre Louis d\u2019Epid\u00e9miologie et de Sant\u00e9 Publique (iPLESP), AP-HP, H\u00f4pital Piti\u00e9 Salp\u00eatri\u00e8re, Service de Virologie, Sorbonne Universit\u00e9, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc-Antoine","family":"Valantin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Piti\u00e9-Salp\u00eatri\u00e8re Hospital, Assistance Publique-H\u00f4pitaux de Paris (APHP), Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM U1136, Sorbonne University, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Solas","sequence":"additional","affiliation":[{"name":"Assistance Publique-H\u00f4pitaux de Marseille (APHM), H\u00f4pital La Timone, Laboratoire de Pharmacocin\u00e9tique et Toxicologie, INSERM 1207, IRD 190, Unit\u00e9 des Virus Emergents, Aix-Marseille Universit\u00e9, 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Veyri","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Piti\u00e9 Salp\u00eatri\u00e8re Hospital, Assistance Publique-H\u00f4pitaux de Paris (APHP), Institut Universitaire de Canc\u00e9rologie (IUC), CLIP2 Galil\u00e9e, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM U1136, Sorbonne Universit\u00e9, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Philippe","family":"Spano","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Piti\u00e9 Salp\u00eatri\u00e8re Hospital, Assistance Publique-H\u00f4pitaux de Paris (APHP), Institut Universitaire de Canc\u00e9rologie (IUC), CLIP2 Galil\u00e9e, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM U1136, Sorbonne Universit\u00e9, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Makinson","sequence":"additional","affiliation":[{"name":"Centre Hospitalier Universitaire de Montpellier, D\u00e9partement des Maladies Infectieuses et Tropicales, INSERM U1175\/IRD UMI 233, 34000 Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/S1473-3099(10)70026-8","article-title":"IeDEA Southern and Central Africa Immune reconstitution inflammatory syndrome in patients starting antiretroviral therapy for HIV infection: A systematic review and meta-analysis","volume":"10","author":"Wandel","year":"2010","journal-title":"Lancet Infect. 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