Photodynamic therapy in AIDS-related cutaneous Kaposi's sarcoma

Article Abstract:

Photodynamic therapy (PDT) for treatment of AIDS-related cutaneous Kaposi's sarcoma (KS) is not recommended because of side effects and a disfiguring result. Eight HIV-positive homosexual men received nine treatments of Photofrin and laser light on a total of 83 lesions. Side effects included swelling, muscle stiffness, blisters, pain, scarring, and increased pigmentation of the lesion. Itching and blistering resulted from an inflammatory reaction. Tumors on the head and neck tended to respond better to photodynamic therapy than tumors on the extremities, possibly because these lesions were younger tumors. Larger, raised lesions recurred more often which could be due to unsatisfactory light penetration. The response rate of PDT of 60-70% at five months in this study is considered on par with other treatments such as chemotherapy and radiotherapy, but the side effects prohibit recommendation.

Evaluation, Kaposi's sarcoma, Photochemotherapy

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Design and assessment of cost-effectiveness studies in AIDS populations

Article Abstract:

Cost-effectiveness analyses of treatment for HIV and AIDS must be interpreted cautiously because of the variability methods of treatment and analysis. Because HIV infection may be treated by many drugs at a time and at different disease stages, economic evaluation of single drugs is complicated. Furthermore, different economic studies vary in what costs they include, what outcomes they measure, and whose cost perspective they consider. Such studies must account for the differences between treatment in a clinical trial and treatment in the community. They must also adjust for differences in inherent social and biological risks between populations. People who make care decisions should evaluate economic studies based on the changing practices in this developing field and on the ability of studies to avoid the problems of analysing HIV treatment.

Analysis, AIDS (Disease), Cost (Economics), Costs (Economics)

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