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Clinical outcomes of HIV ‐infected patients with K aposi's sarcoma receiving nonnucleoside reverse transcriptase inhibitor‐based antiretroviral therapy in U ganda
Author(s) -
Asiimwe FM,
Moore DM,
Were W,
Nakityo R,
Campbell J,
Barasa A,
Mermin J,
Kaharuza F
Publication year - 2012
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.1468-1293.2011.00955.x
Subject(s) - medicine , hazard ratio , odds ratio , confidence interval , reverse transcriptase inhibitor , gastroenterology , immunology , viral load , antiretroviral therapy , human immunodeficiency virus (hiv)
Background Clinical outcomes for patients with K aposi's sarcoma ( KS ) using nonnucleoside reverse transcriptase inhibitor ( NNRTI )‐based highly active antiretroviral therapy ( HAART ) in resource‐limited settings have not previously been described. Methods We evaluated HIV ‐infected patients aged ≥ 18 years, who initiated HAART in the H ome‐ B ased AIDS C are ( HBAC ) project in T ororo, U ganda, between M ay 2003 and F ebruary 2008 and were diagnosed with KS at baseline or during follow‐up. We examined independent risk factors for having either prevalent or incident KS and risk factors for death among patients with KS . Results Of 1121 study subjects, 17 (1.5%) were diagnosed with prevalent KS and 18 (1.6%) with incident KS over a median of 56.1 months of follow‐up. KS was associated with male sex [adjusted odds ratio ( AOR ) 2.41; 95% confidence interval ( CI ) 1.20–4.86] and baseline CD 4 cell count < 50 cells/μ L ( AOR 3.25; 95% CI 1.03–10.3). Eleven (65%) of 17 patients with prevalent KS and 13 (72%) of 18 patients with incident KS experienced complete regression ( P = 0.137). Eighteen (64%) of 28 patients who remained on NNRTI ‐based HAART experienced regression of their KS and six (86%) of seven patients who were switched to protease inhibitor‐containing HAART regimens had regression of their KS ( P = 0.23). Mortality among those with KS was significantly associated with visceral disease (hazard ratio 19.22; 95% CI 2.42–152). Conclusion Prevalent or incident KS was associated with 30% mortality. The resolution of KS lesions among individuals who initiated HAART with NNRTI ‐based regimens was similar to that found in studies using only protease inhibitor‐based HAART .