Procedures
syphilis, Epstein-Barr Virus (EBV) VL ELITe, tumor necrosis, oropharyngeal lesions
INFECTIOUS DISEASES, TUMOR NECROSIS, SYPHILIS, BLOOD, SKIN LESIONS
Patients who at the time of diagnosis presented with extensive KS involvement or bulky oropharyngeal lesions were treated with vincristine 2 mg (reduced to 1 mg if albumin was <3 g/dL) plus bleomycin 15 UI before cART, or at follow-up in case of S-IRIS-KS or persistence of extensive KS lesions.Visits were scheduled at baseline, and weeks 1, 2, 4, 8, 12, 16, 24, and 48. At each visit, an Infectious Diseases specialist performed a clinical evaluation and skin lesions were photographed. Blood samples were obtained for: WBC count, complete blood chemistry, urine analysis, CRP, D-Dimer, HIV VL with Abbott Real-time, HHV-8, CMV, and Epstein-Barr Virus (EBV) VL ELITe MGB KIT by ELITe InGenius Software, CD4+, and CD8+ cells count and percentage, (flow cytometry, Facs Canto II, Becton Dickinson). CD4/CD8 ratio and plasma levels of interleukin 6, 10 (IL-6, IL-10), tumor necrosis factor (TNF), and interferon-gamma (IFN-ɤ) were measured using a sandwich-type immunoassay, ELISA (Biolegend). Serology for syphilis, HBV, and HCV was repeated at weeks 24 and 48. If patients had an exacerbation of KS outside the scheduled visit they were re-evaluated with laboratory tests and image studies.