No increased risk of Kaposi sarcoma relapse in patients with controlled HIV‐1 infection after switching protease inhibitor‐based antiretroviral therapy.

Objectives: Our aim was to assess if switching from a protease inhibitors (PI)‐based regimen to a PI‐free one is associated with an increased risk of Kaposi Sarcoma (KS) relapse among patients living with HIV (PLHIV) with history of KS and controlled HIV replication. Methods: In a retrospective analysis of the prospectively collected Dat'AIDS database we selected patients who both had a past KS history and a HIV‐1 viral load below 200 copies/mL while being PI‐treated. We searched for KS relapses while persistent virological success was maintained for at least 6 months, whether patients kept taking the PI, or switched to PI‐free regimen. Results: Among the 216 patients with past KS event and a history of HIV‐1 infection efficiently treated by a PI‐based regimen, 148 patients (68.5%) later switched to a PI‐sparing regimen. Their baseline characteristics were not different from non‐switching patients. We described 7 cases of relapse (3.2% of the 216 patients). Five cases of relapse occurred in switching patients (3.4%). The remaining two relapses occurred in PI‐treated patients (2.9%). At KS relapse, CD4 cell count was 459 cells/μL (range 225–560) for switching patients, compared with 362 and 136 cells/μL for the other two patients. Conclusions: In this large cohort of PLHIV with a history of KS and ART‐controlled HIV replication, KS relapses were described in 3.2% of the patients, and were not more frequent when a PI‐containing ART regimen has been switched to a PI‐free regimen. Our results do not support a specific effect of PI on KS. [ABSTRACT FROM AUTHOR]