“In this country (USA), in 1996, when we saw antiretroviral drugs appear, we thought that SK [Kaposi's sarcoma] had disappeared. And we thought it was the end of SK. Well, not so fast, ”said Toby Maurer, MD, professor of clinical dermatology at the University of California, San Francisco and a great doctor at the HIV clinic at San Francisco General Hospital.
Kaposi's sarcoma - so common during the height of the epidemic, people living with HIV and AIDS AND is best known as the prototype of the AIDS-defining disease. It is caused by the human herpes virus 8 (HHV-8) and usually results in skin lesions with a distinct dark color on the skin or inside the mouth, in the respiratory or gastrointestinal tract.
Maurer draws attention to the fact that corticosteroids, such as prednisone, can trigger the appearance of skin lesions (SK) in people who are infected with HHV-8, but have never had symptoms of SK before. “I can't tell you how many times a week I see SK being linked to prednisone. And not only am I seeing this in the HIV-infected group, but HIV-negative gay men in San Francisco have also seen these injuries. I probably see three to four people a month who are developing steroid-activated SK. ”
Many people - both those with and without HIV, are infected with the herpes virus that is responsible for SK. It is not entirely clear how HHV-8 is transmitted, but it is likely that HHV-8 is transmitted orally and / or sexually. It is estimated that Between 30% and 60% of HIV-positive patients and 20% or 30% of HIV-negative patients men who have sex with men are infected with HHV8.
Issuing a warning, Maurer urged other HIV providers to think twice before prescribing steroid medication. “I am no longer fond of using prednisone for our patients. Obviously, there are times when you need to use prednisone. But if you don't need prednisone, think about it a hundred times. ”
Translated by Cláudio Souza do Original in Prednisone can “turn on” Kaposi's sarcoma in people with HIV By Emily Newman
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