Comparison of Kaposi Sarcoma Risk in Human Immunodeficiency Virus-Positive Adults Across 5 Continents: A Multiregional Multicohort Study

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 fr...

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Bibliographic Details
Published in:Clinical infectious diseases 2017-10, Vol.65 (8), p.1316-1326
Main Authors: Zangerle, Robert, Touloumi, Giota, Warszawski, Josiane, Meyer, Laurence, Dabis, François, Leport, Catherine, Gibb, Diana, Obel, Niels, Thorne, Claire, Bartmeyer, Barbara, Chkhartishvili, Nikoloz, Noguera-Julian, Antoni, d’Arminio Monforte, Antonella, Casabona, Jordi, Miró, Jose M, Goetghebuer, Tessa, Haerry, David, Dunn, David, Matheron, Sophie, Puoti, Massimo, Rohner, Eliane, Tanser, Frank, Malisita, Kennedy, Sawry, Shobna, Boswell, Stephen, Grasso, Chris, Brooks, John T, Gebo, Kelly A, Horberg, Michael A, Silverberg, Michael J, Rabkin, Charles, Jacobson, Lisa P, Cupido, Patrick, Mayor, Angel M, Bebawy, Sally, Althoff, Keri N, McKaig, Rosemary G, Lent, Carol, Lau, Bryan, Zhang, Jinbing, Wong, Cherise, Fink, Valeria, Sued, Omar, Perez, Hector, Luz, Paula, de Boni, Raquel, Friedman, Ruth, Maria Machado, Daisy, Cortes, Claudia, Marcelin, Adias, Sierra Madero, Juan, Carriquiry, Gabriela, McGowan, Catherine C, Sterling, Timothy, Giganti, Mark, Castilho, Jessica, Duda, Stephany N, Ly, P S, Zhao, H X, Lam, W, Kumarasamy, N, Saghayam, S, Ezhilarasi, C, Joshi, K, Merati, T P, Oka, S, Choi, J Y, Syed Omar, S F, Ponnampalavanar, S, Wong, W W, Lee, L S, Chaiwarith, R, Praparattanapan, J, Nguyen, D T H, Cuong, D D, Sohn, A H, Boettiger, D C, Ellis, D, Allen, D, Rankin, A, O’Connor, C C, Carr, A, Langton-Lockton, J, Shakeshaft, J, Varma, R, Han, A, Gunathilake, M, Roberts, C, Sowden, D, Taing, K, Marshall, P, Youds, D, Read, T, Silvers, J, Bryant, M, Giles, M, Nolan, D, Allen, A, Mills, G, Bargh, K
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
Adolescent
Adult
Adults
AIDS
and Commentaries
Anti-Retroviral Agents - therapeutic use
Antiretroviral agents
Antiretroviral therapy
ARTICLES AND COMMENTARIES
CD4 antigen
CD4 Lymphocyte Count
Cohort Studies
Comparative analysis
Confidence intervals
Continents
Female
HIV
HIV Infections - complications
HIV Infections - drug therapy
HIV Infections - epidemiology
HIV-1
Human health and pathology
Human immunodeficiency virus
Humans
Incidence
Kaposis sarcoma
Life Sciences
Male
Medical research
Middle Aged
Patients
Risk
Risk Factors
Sarcoma
Sarcoma, Kaposi - epidemiology
Sarcoma, Kaposi - etiology
Sexually transmitted diseases
STD
Viral Load
Viruses
Young Adult
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Summary: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/μL with those whose counts were
ISSN:1058-4838
1537-6591
DOI:10.1093/cid/cix480