🏳️‍🌈✝️ Prednisone can “turn on” Kaposi’s sarcoma in people with HIV

 By Emily Newman

 August 20, 2015

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“In this country, in 1996 when we saw those antiretrovirals come out, KS [Kaposi sarcoma] all but disappeared. And we thought that was the end of KS. Well, not so fast,” said Toby Maurer, M.D., University of California, San Francisco professor of clinical dermatology at an HIV grand rounds presentation at San Francisco General Hospital.

Kaposi’s sarcoma skin lesions

 (Photo: National Cancer Institute)

Kaposi’s sarcoma—so common during the height of the epidemic in people with HIV and AIDS—is best-known as the prototypical AIDS-defining illness. It is caused by the human herpes virus 8 (HHV-8) and typically results in distinctive, dark-colored skin lesions on the skin or inside the mouth, respiratory or gastrointestinal tract.

Maurer warns that steroids, such as prednisone, can trigger the emergence of KS skin-lesions in people who are infected with HHV-8 but have never shown symptoms of KS before. “I can’t tell you how many times a week I see KS being turned on by prednisone. And not only am I seeing this in the HIV-infected group, but in the gay HIV-negative group in San Francisco. I’m probably seeing maybe three or four people a month who are getting KS turned on by steroids.”

Many people—both those with and without HIV—are infected with the herpes virus that is responsible for KS. It is not entirely clear how HHV-8 is transmitted, but it is though that HHV-8 is transmitted orally and/or sexually. It is estimated that between 30% and 60% of HIV-positive and 20-30% of HIV-negative men who have sex with men are infected with HHV-8.

Issuing a warning, Maurer urged other HIV providers to think twice before prescribing steroid medications. “I am not a lover of using prednisone for our patients anymore. Obviously, there are times when you’ve got to use prednisone. But if you don’t need the prednisone, think about it a hundred times.”

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