Rohner, Eliane ORCID: 0000-0002-0554-2875, Butikofer, Lukas ORCID: 0000-0002-0801-746X, Schmidlin, Kurt, Sengayi, Mazvita, Maskew, Mhairi, Giddy, Janet, Garone, Daniela, Moore, Richard D., D'Souza, Gypsamber, Goedert, James J., 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, Paparizos, Vassilios, Bonnet, Fabrice, Verbon, Annelies, Fatkenheuer, Gerd, Post, Frank A., Sabin, Caroline, Mocroft, Amanda, Le Moing, Vincent ORCID: 0000-0002-9529-2792, Dronda, Fernando, Obel, Niels, Grabar, Sophie, Spagnuolo, Vincenzo ORCID: 0000-0002-9656-7217, Antinori, Andrea ORCID: 0000-0003-2121-4684, Quiros-Roldan, Eugenia, Mussini, Cristina, Miro, Jose M., Meyer, Laurence, Hasse, Barbara, Konopnicki, Deborah, Roca, Bernardino, Barger, Diana, Raben, Dorthe, Clifford, Gary M., Franceschi, Silva, Brookmeyer, Norbert, Chakraborty, Rana, Egger, Matthias ORCID: 0000-0001-7462-5132 and Bohlius, Julia (2017). Comparison of Kaposi Sarcoma Risk in Human Immunodeficiency Virus-Positive Adults Across 5 Continents: A Multiregional Multicohort Study. Clin. Infect. Dis., 65 (8). S. 1316 - 1327. CARY: OXFORD UNIV PRESS INC. ISSN 1537-6591

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Abstract

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.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Rohner, ElianeUNSPECIFIEDorcid.org/0000-0002-0554-2875UNSPECIFIED
Butikofer, LukasUNSPECIFIEDorcid.org/0000-0002-0801-746XUNSPECIFIED
Schmidlin, KurtUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sengayi, MazvitaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maskew, MhairiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Giddy, JanetUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Garone, DanielaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Moore, Richard D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
D'Souza, GypsamberUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Goedert, James J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Achenbach, ChadUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gill, M. JohnUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kitahata, Mari M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Patel, PragnaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Silverberg, Michael J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Castilho, JessicaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
McGowan, CatherineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chen, Yi-Ming ArthurUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Law, MatthewUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Taylor, NinonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Paparizos, VassiliosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bonnet, FabriceUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Verbon, AnneliesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fatkenheuer, GerdUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Post, Frank A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sabin, CarolineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mocroft, AmandaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Le Moing, VincentUNSPECIFIEDorcid.org/0000-0002-9529-2792UNSPECIFIED
Dronda, FernandoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Obel, NielsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Grabar, SophieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Spagnuolo, VincenzoUNSPECIFIEDorcid.org/0000-0002-9656-7217UNSPECIFIED
Antinori, AndreaUNSPECIFIEDorcid.org/0000-0003-2121-4684UNSPECIFIED
Quiros-Roldan, EugeniaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mussini, CristinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Miro, Jose M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Meyer, LaurenceUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hasse, BarbaraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Konopnicki, DeborahUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Roca, BernardinoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Barger, DianaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Raben, DortheUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Clifford, Gary M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Franceschi, SilvaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brookmeyer, NorbertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chakraborty, RanaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Egger, MatthiasUNSPECIFIEDorcid.org/0000-0001-7462-5132UNSPECIFIED
Bohlius, JuliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-214230
DOI: 10.1093/cid/cix480
Journal or Publication Title: Clin. Infect. Dis.
Volume: 65
Number: 8
Page Range: S. 1316 - 1327
Date: 2017
Publisher: OXFORD UNIV PRESS INC
Place of Publication: CARY
ISSN: 1537-6591
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
INTERNATIONAL EPIDEMIOLOGIC DATABASES; COMBINATION ANTIRETROVIRAL THERAPY; HIV-INFECTED PATIENTS; EVALUATE AIDS IEDEA; SUB-SAHARAN AFRICA; COHORT PROFILE; CANCER INCIDENCE; PATHOGENESIS; COLLABORATION; ASCERTAINMENTMultiple languages
Immunology; Infectious Diseases; MicrobiologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/21423

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