Mentored Scientist Award

We recently reported the clinical and epidemiological characteristics of an atypical group of patients who developed Kaposi sarcoma (KS) in spite of having suppressed HIV and relatively higher CD4+ counts. Given similarities in clinical presentation between the KS of these long-term treated patients and the classical KS observed in HIV-- elderly, we postulated that immunosenescence may be causally associated with emergence of KS. Preliminary results support this association, revealing higher levels of T cell immunosenescence marker CD57+ on both CD4+ and CD8+ T cells of HIV+ KS+ subjects vs. HIV+ KS-- subjects (all on long term HAART). However, more information is needed concerning the role of premature immunologic aging in the more common manifestations of KS, particularly in KS that develops in poorly controlled or untreated HIV. In our proposed follow-up study, we investigate the role of T cell dysfunction and immunosenescence as a determinant of treatment responses in HAART-untreated patients who present with KS. Specifically we determine and compare markers of T cell immunosenescence in untreated patients whose KS persists or worsens during HAART (KS nonremitters) vs. wanes during HAART (KS remitters)