Pulmonary Kaposi sarcoma in the era of highly active antiretroviral therapy.

Abstract

OBJECTIVE:

Since the introduction of highly active antiretroviral therapy (HAART) there has been a dramatic reduction in the incidence of Kaposi sarcoma (KS) and an improvement in survival. We wished to examine whether the outcome in pulmonary KS (pKS) has also altered.

METHODS:

In a single-institution cohort of 1140 HIV-positive patients with KS, 305 patients were diagnosed in the HAART era (1996-2004). We examined the clinicopathological features and outcomes of these patients, of whom 25 had pKS and 280 did not.

RESULTS:

Patients with pKS had lower CD4 cell counts at the time of KS diagnosis (Mann-Whitney U-test P=0.005). The incidence of pKS was higher in African patients than in non-African patients in this sample (Fisher's test, P=0.001). There were no significant differences in age, gender, plasma HIV-1 viral load or prior HAART treatment at the time of KS diagnosis. Five-year overall survival in the pKS group was 49% [95% confidence interval (CI) 26-73%] as compared with 82% (95% CI 76-87%) for the non-pKS group (log rank, P<0.0001).

CONCLUSION:

PKS remains an ominous diagnosis in the era of HAART, with a median survival of just 1.6 years.

• Authors: C Palmieri, T Dhillon, C Thirlwell, T Newsom-Davis, A-M Young, M Nelson, B G Gazzard, M Bower
• Journal: HIV medicine (HIV Med) Vol. 7 Issue 5 Pg. 291-3 (Jul 2006) ISSN: 1464-2662 [Print] England
• PMID: 16945073 (Publication Type: Journal Article)

Topics

• AIDS-Related Opportunistic Infections (complications, epidemiology)
• Adult
• Aged
• Antiretroviral Therapy, Highly Active
• Black People
• CD4 Lymphocyte Count
• Female
• HIV Infections (complications, epidemiology)
• HIV-1
• Humans
• London (epidemiology)
• Lung Neoplasms (complications, epidemiology)
• Male
• Middle Aged
• Prospective Studies
• Sarcoma, Kaposi (complications, epidemiology)
• Survival Analysis