Incidence and trends in Kaposi's sarcoma in the era of effective antiretroviral therapy.

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Incidence and trends in Kaposi's sarcoma in the era of effective antiretroviral therapy.

J Acquir Immune Defic Syndr. 2000 Jul 1;24(3):270-4. Unique Identifier : AIDSLINE MED/20429906
Jones JL; Hanson DL; Dworkin MS; Jaffe HW; Division of HIV/AIDS Prevention Surveillance and Epidemiology,; National Center for HIV, STD, and TB Prevention, National Center; for Infectious Diseases, Centers for Disease Control and; Prevention, Atlanta, GA 30341-3724, USA.

Abstract: OBJECTIVE: To evaluate the impact of antiretroviral and antiherpesvirus therapies on the incidence of KS and assess trends in incidence of Kaposi's sarcoma (KS) in a large multicenter HIV/AIDS surveillance system between 1990 and 1998. METHODS: Incidence was calculated per 100 person-years (py); the effects of therapies on risk for KS were calculated by using multivariate Poisson regression controlling for gender, race/ethnicity, age, HIV exposure mode, CD4+ cell count, and calendar year. Antiretroviral therapy was defined as monotherapy, dual therapy, or triple therapy (95% of triple therapy regimens contained a protease inhibitor). Acyclovir, ganciclovir, and foscarnet were the antiherpesvirus therapies evaluated. RESULTS: There were 37,303 HIV-infected people in the study contributing 70,238 py. Those prescribed triple antiretroviral therapy had a 50% reduction in the incidence of KS (95% confidence interval, 20%-70%) compared with those who were not prescribed antiretroviral therapy and there was a reduction in risk for KS among persons prescribed foscarnet (p =.05). Overall, KS incidence declined an estimated 8.8% per year (observed incidence 4. 1 per 100 py in 1990 to 0.7 per 100 py in 1998; p <.001). CONCLUSION: Incidence of KS is declining in this large U.S. population and may continue to decline as new, more effective antiretroviral agents are developed and used widely.

Keywords: JOURNAL ARTICLE Acyclovir/THERAPEUTIC USE Adult Anti-HIV Agents/*THERAPEUTIC USE AIDS-Related Opportunistic Infections/*EPIDEMIOLOGY/ETIOLOGY Drug Therapy, Combination Female Foscarnet/THERAPEUTIC USE Ganciclovir/THERAPEUTIC USE Homosexuality, Male Human HIV Infections/*COMPLICATIONS/DRUG THERAPY/IMMUNOLOGY Incidence Male Middle Age Multicenter Studies Retrospective Studies Risk Factors Sarcoma, Kaposi/*EPIDEMIOLOGY/ETIOLOGY Skin Neoplasms/*EPIDEMIOLOGY/ETIOLOGY

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