A case of acquired immunodeficiency syndrome-related Kaposi sarcoma in a patient with COVID-19 - A brief review of HIV-COVID Co-infection and its Therapeutic challenges!

ABSTRACT

Barriers posed by the COVID-19 pandemic have led to reduced access to Human Immunodeficiency virus (HIV) care, leaving untreated patients at risk for various superimposed infections and malignancies such as Kaposi sarcoma (KS). We recently encountered a 37-year-old African-American male with a past medical history of HIV who tested positive for SARS-CoV-2 and was diagnosed with AIDS-related disseminated KS, representing the first reported case of COVID-19 infection with a newly diagnosed concomitant KS. The patient experienced multi-organ failure requiring tracheostomy, renal replacement therapy, and a prolonged intensive care unit (ICU) stay. Goals of care were changed to comfort measures and the patient passed away shortly afterwards. He was made comfort measures and passed away shortly afterwards. AIDS-related KS is a vascular tumor seen in association with Human Herpes Virus-8 (HHV-8). Management of limited AIDS-related KS typically includes combined antiretroviral therapy (ART) while multi-organ KS disease demands systemic chemotherapy. Immunosuppression should be avoided in patients with AIDS-related KS as it can lead to progression of KS. This recommendation is in conflict with the usual standard of care for patients with COVID-19 pneumonia, requiring clinical judgment and a customized approach based on the stage and severity of both the KS and the COVID-related disease. We briefly review HIV-COVID-19 coinfection, AIDS related KS and challenges associated with their management.