: We describe the first case of a patient presenting Kaposi's sarcoma with human herpes virus 8 (HHV8) viremia after switching from a protease inhibitor to an integrase inhibitor-based combination antiretroviral therapy, followed by a rapid remission when resuming protease inhibitor. We suggest that the recent recommendations to switch all HIV patients to protease inhibitor-free regimens should be carefully re-evaluated especially in MSM HIV patients which are at higher risks of HHV8 infections and associated malignancies.