AEGiS-15IAC: Human immunodeficiency virus associated Kaposi's Sarcoma: Demographic, clinical, immunological and virological characteristics of 124 South African patients.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Human immunodeficiency virus associated Kaposi's Sarcoma: Demographic, clinical, immunological and virological characteristics of 124 South African patients.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. C10052)

Mosam A, Coovadia HM, Cassol S, Cassol E, Page T, Bodasing U, Dawood H, Lalloo UG, Jordaan JP, Chetty R, Scadden DT, Friedland GH
Nelson R Mandela, Durban, South Africa

BACKGROUND: As HIV is a silent disease and >90% of individuals are unaware of their infection status it is necessary to establish visible and accessible points of treatment entry. We assessed the commonest malignancy associated with HIV/AIDS, Kaposi's sarcoma (KS) as an entry point to antiretroviral therapy. Aim: To assess the demographic, clinical, immunological and virological parameters in patients with HIV -1 associated KS in South Africa.

METHOD: A cross sectional study of all patients with HIV KS. They were assessed for: demographic data, staging of KS, opportunistic infections, blood count, renal and liver function tests, CD4+ and CD8+ subsets, HIV-1 viral loads and HHV 8 serology.

RESULTS: Of a total of 124 patients, 123 were Black and 1 White with 67 males and 57 males, hence a M: F of 1:1.1. The mean age was 35.74 years (19-67yrs ). The route of HIV-1 transmission in 123 was heterosexual and in 1 homosexual. Sixty five had GOOD and 59 POOR risk disease. Tuberculosis was present in 34 (27.2%)and oral candida in 10(7.8%). Mean CD4+ was 208.5 cells/mm³ (1-1005 ) and CD8+ 1221.34 (154-3023 ) cells/mm³ with 70 (56%)< 200 cells/mm³, 22 (17.6%)between 200 and 349 cells/mm³ and 25(20.8%) >350 cells/mm³. Mean HIV-1 viral load was 5.14 log (0.59 SD) with 26(20.2%) between 0-4,73 log and 87(69.6%)>between 4.74-6.4log VL. Latent HHv 8 antibody testing in a subset of 60 was positive in 48/60 (80%) and negative in 12/60 (20%), lytic antibody test was positive in 59/60 (98.3%) and negative in 1/60 (1.7%).

CONCLUSION: HIV KS is predominantly a disease of Blacks with an equal female to male ratio. Opportunistic infections are present in a third, the commonest being Tuberculosis. Although 56% have CD4< 200, a significant proportion( 20.8%) have CD4>350, hence not all patients suffer marked immunosuppression. However, this group will still qualify for ART based on KS being AIDS-defining criterion.

Keywords: AEGIS, Sarcoma, Kaposi, Acquired Immunodeficiency Syndrome, Herpesvirus 8, Human, HIV-1, HIV Seropositivity, African Continental Ancestry Group, Homosexuality, Candidiasis, Oral, European Continental Ancestry Group, Tuberculosis, Cross-Sectional Studies, South Africa, Humans, Male, Female, virology, immunology

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C10052