Activity of thalidomide in AIDS-related Kaposi's sarcoma and correlation with HHV8 titre

• Published in: International journal of STD & AIDS Vol. 9; no. 12; p. 751
• Main Authors: Fife, K, Howard, M R, Gracie, F, Phillips, R H, Bower, M
• Format: Journal Article
• Language: English
• Published: England 01-12-1998
• Subjects: Adult; AIDS-Related Opportunistic Infections - drug therapy; Dermatologic Agents - therapeutic use; Herpesvirus 8, Human - drug effects; Humans; Male; Middle Aged; Polymerase Chain Reaction; Sarcoma, Kaposi - drug therapy; Thalidomide - therapeutic use
• ISSN: 0956-4624
• DOI: 10.1258/0956462981921512

A phase II study of thalidomide was conducted to evaluate its efficacy and toxicity in the treatment of cutaneous AIDS-related Kaposi's sarcoma (AIDS-KS). To evaluate whether clinical response is correlated with titre of human herpesvirus 8 (HHV8) DNA in peripheral blood, levels were determined by serial end-point dilution at enrolment and 4-6 weeks later. Seventeen male HIV-seropositive patients with histopathologically diagnosed KS were treated with thalidomide 100mg orally once nightly for 8 weeks. Response evaluation was performed using AIDS Clinical Trials Group (ACTG) criteria and analysis was by intention to treat. Six of 17 patients achieved a partial response (35%: 95% confidence interval 10-61%). Eight patients withdrew (6 owing to toxicity, one to early progression and one to non-compliance). HHV8 DNA load decreased by at least 3log10 to undetectable levels in 3 of the 5 virologically assessable partial responders. This preliminary study demonstrates that thalidomide has activity in the treatment of AIDS-KS and that clinical response is associated with a reduction of HHV8 DNA titre in peripheral blood.