TY - JOUR
TI - Comparison of Kaposi Sarcoma Risk in Human Immunodeficiency
Virus-Positive Adults Across 5 Continents: A Multiregional Multicohort
Study
AU - Rohner, Eliane
AU - Butikofer, Lukas
AU - Schmidlin, Kurt
AU - Sengayi,
AU - Mazvita
AU - Maskew, Mhairi
AU - Giddy, Janet
AU - Garone, Daniela and
AU - Moore, Richard D.
AU - D'Souza, Gypsamber
AU - Goedert, James J. and
AU - Achenbach, Chad
AU - Gill, M. John
AU - Kitahata, Mari M.
AU - Patel,
AU - Pragna
AU - Silverberg, Michael J.
AU - Castilho, Jessica
AU - McGowan,
AU - Catherine
AU - Chen, Yi-Ming Arthur
AU - Law, Matthew
AU - Taylor, Ninon
AU - and Paparizos, Vassilios
AU - Bonnet, Fabrice
AU - Verbon, Annelies and
AU - Fatkenheuer, Gerd
AU - Post, Frank A.
AU - Sabin, Caroline
AU - Mocroft,
AU - Amanda
AU - Le Moing, Vincent
AU - Dronda, Fernando
AU - Obel, Niels and
AU - Grabar, Sophie
AU - Spagnuolo, Vincenzo
AU - Antinori, Andrea and
AU - Quiros-Roldan, Eugenia
AU - Mussini, Cristina
AU - Miro, Jose M. and
AU - Meyer, Laurence
AU - Hasse, Barbara
AU - Konopnicki, Deborah
AU - Roca,
AU - Bernardino
AU - Barger, Diana
AU - Raben, Dorthe
AU - Clifford, Gary M. and
AU - Franceschi, Silva
AU - Brookmeyer, Norbert
AU - Chakraborty, Rana and
AU - Egger, Matthias
AU - Bohlius, Julia
AU - The Aids-Defining Cancer Project
AU - and Cohere In EuroCoord
JO - Clinical Infectious Diseases
PY - 2017
VL - 65
TODO - 8
SP - 1316-1326
PB - OXFORD UNIV PRESS INC
SN - 1058-4838, 1537-6591
TODO - 10.1093/cid/cix480
TODO - Kaposi sarcoma; HIV; antiretroviral therapy; cohort study
TODO - Background. We compared Kaposi sarcoma (KS) risk in adults who started
antiretroviral therapy (ART) across the Asia-Pacific, South Africa,
Europe, Latin, and North America.
Methods. We included cohort data of human immunodeficiency virus
(HIV)-positive adults who started ART after 1995 within the framework of
2 large collaborations of observational HIV cohorts. We present
incidence rates and adjusted hazard ratios (aHRs).
Results. We included 208 140 patients from 57 countries. Over a period
of 1 066 572 person-years, 2046 KS cases were diagnosed. KS incidence
rates per 100 000 person-years were 52 in the Asia-Pacific and ranged
between 180 and 280 in the other regions. KS risk was 5 times higher in
South African women (aHR, 4.56; 95% confidence intervals [CI],
2.73-7.62) than in their European counterparts, and 2 times higher in
South African men (2.21; 1.34-3.63). In Europe, Latin, and North America
KS risk was 6 times higher in men who have sex with men (aHR, 5.95; 95%
CI, 5.09-6.96) than in women. Comparing patients with current CD4 cell
counts >= 700 cells/mu L with those whose counts were <50 cells/mu L,
the KS risk was halved in South Africa (aHR, 0.53; 95% CI,.17-1.63) but
reduced by >= 95% in other regions.
Conclusions. Despite important ART-related declines in KS incidence, men
and women in South Africa and men who have sex with men remain at
increased KS risk, likely due to high human herpesvirus 8 coinfection
rates. Early ART initiation and maintenance of high CD4 cell counts are
essential to further reducing KS incidence worldwide, but additional
measures might be needed, especially in Southern Africa.
ER -