Περίληψη:
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.
Συγγραφείς:
Rohner, Eliane
Butikofer, Lukas
Schmidlin, Kurt
Sengayi,
Mazvita
Maskew, Mhairi
Giddy, Janet
Garone, Daniela and
Moore, Richard D.
D'Souza, Gypsamber
Goedert, James J. and
Achenbach, Chad
Gill, M. John
Kitahata, Mari M.
Patel,
Pragna
Silverberg, Michael J.
Castilho, Jessica
McGowan,
Catherine
Chen, Yi-Ming Arthur
Law, Matthew
Taylor, Ninon
and Paparizos, Vassilios
Bonnet, Fabrice
Verbon, Annelies and
Fatkenheuer, Gerd
Post, Frank A.
Sabin, Caroline
Mocroft,
Amanda
Le Moing, Vincent
Dronda, Fernando
Obel, Niels and
Grabar, Sophie
Spagnuolo, Vincenzo
Antinori, Andrea and
Quiros-Roldan, Eugenia
Mussini, Cristina
Miro, Jose M. and
Meyer, Laurence
Hasse, Barbara
Konopnicki, Deborah
Roca,
Bernardino
Barger, Diana
Raben, Dorthe
Clifford, Gary M. and
Franceschi, Silva
Brookmeyer, Norbert
Chakraborty, Rana and
Egger, Matthias
Bohlius, Julia
The Aids-Defining Cancer Project
and Cohere In EuroCoord
