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Pulmonary Kaposi sarcoma in the era of highly active antiretroviral therapy
Author(s) -
Palmieri C,
Dhillon T,
Thirlwell C,
NewsomDavis T,
Young AM,
Nelson M,
Gazzard BG,
Bower M
Publication year - 2006
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/j.1468-1293.2006.00378.x
Subject(s) - medicine , incidence (geometry) , confidence interval , sarcoma , cohort , antiretroviral therapy , mann–whitney u test , log rank test , human immunodeficiency virus (hiv) , exact test , viral load , survival analysis , gastroenterology , immunology , pathology , physics , optics
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.