Anti-HIV treatment

Kaposi's sarcoma

If HIV isn’t treated it can mean that the immune system becomes too weak to protect the body against a number of serious illnesses and cancers.

One of these cancers is Kaposi’s sarcoma (usually shortened to KS). It used to be an important cause of illness and death in people with HIV, but is now rare in countries like the UK thanks to effective HIV treatment.

Mild cases of KS can be successfully treated with anti-HIV drugs, but more severe cases, especially if KS affects the internal organs, require treatment with special anti-cancer drugs as well as HIV treatment.

Drug treatment for cancer is called chemotherapy, and an important drug used for KS chemotherapy is pegylated liposomal doxorubicin.

Spanish researchers looked at 96 people who had such treatment. They found that the treatment can have very good outcomes, with 75 patients having a complete or partial response to it. They also found that the rate of relapse was low and that there was a low risk of serious side-effects with pegylated liposomal doxorubicin.

But they also found that 29 patients died in the two years after completing treatment. Only three of these deaths were associated with KS. However many of the other deaths were due to other cancers, particularly lymphoma.

The researchers found that all the patients who developed a lymphoma were infected with the virus HHV-8, which is a kind of herpes virus. It is thought to be the underlying cause of KS and some other cancers as well.

In a comment on the study, some other doctors note that chemotherapy could itself increase the risk of a second cancer developing. Drugs like pegylated liposomal doxorubicin have been associated with an increased risk of non-Hodgkin’s lymphoma in patients with leukaemia. They therefore recommend that mild or moderate KS should be treated with anti-HIV drugs alone. The use of chemotherapy should be reserved for the most severe forms of the cancer.

Sexual problems

People with HIV can and do have happy and fulfilling sex lives. But just like anyone else, people with HIV can encounter a range of sexual difficulties, such as loss of interest in sex, problems with ejaculation, or difficulty getting an erection.

A technical term for such problems is sexual dysfunction.

It can have medical causes, be due to the side-effects of some drugs, or have psychological causes.

Now researchers have found that a third of HIV-positive patients in France have sexual problems.

The study involved a lot of people , 1800 in total, and it was also quite representative of the communities affected by HIV. One in three people reported having sexual problems in the last month. The researchers found that treatment side-effects (including lipodystrophy) and experiencing discrimination were associated with an increased likelihood of reporting sexual problems.