Panel’s Recommendations

Effective suppression of HIV replication with combination antiretroviral therapy (cART) is recommended to reduce the risk of human herpesvirus 8- (HHV-8)—associated Kaposi sarcoma (AIII). Routine testing to identify HHV-8—seropositive, HIV-infected patients is not recommended (BIII). Effective suppression of HIV replication with cART is recommended for all patients with evidence of active KS and other human herpesvirus 8-associated malignant lymphoproliferative disorders (AIII). The use of intravenous ganciclovir or oral valganciclovir is recommended for treatment of HHV-8—associated multicentric Castleman disease (BIII) and may be a useful adjunct for treating HHV-8-associated primary effusion lymphoma (BIII). Appropriate chemotherapy, in combination with potent cART, should be considered for patients with visceral KS or primary effusion lymphoma (BII*).

Rating of Recommendations: A = Strong; B = Moderate; C = Optional

Rating of Evidence: I = One or more randomized trials in children^† with clinical outcomes and/or validated endpoints; I* = One or more randomized trials in adults with clinical outcomes and/or validated laboratory endpoints with accompanying data in children^† from one or more well-designed, nonrandomized trials or observational cohort studies with long-term clinical outcomes; II = One or more well-designed, nonrandomized trials or observational cohort studies in children^† with long-term outcomes; II* = One or more well-designed, nonrandomized trials or observational studies in adults with long-term clinical outcomes with accompanying data in children^† from one or more similar nonrandomized trials or cohort studies with clinical outcome data; III = Expert opinion

^†Studies that include children or children/adolescents, but not studies limited to post-pubertal adolescents.