Kaposi Sarcoma Risk in HIV-Infected Children and Adolescents on Combination Antiretroviral Therapy From Sub-Saharan Africa, Europe, and Asia

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  • Eliane Rohner
  • Kurt Schmidlin
  • Marcel Zwahlen
  • Rana Chakraborty
  • Gary Clifford
  • Obel, Niels
  • Sophie Grabar
  • Annelies Verbon
  • Antoni Noguera-Julian
  • Ali Judd
  • Intira Jeannie Collins
  • Pablo Rojo
  • Norbert Brockmeyer
  • Maria Campbell
  • Geneviève Chêne
  • Hans Prozesky
  • Brian Eley
  • D Cristina Stefan
  • Alan Davidson
  • Cleophas Chimbetete
  • Shobna Sawry
  • Mary-Ann Davies
  • Azar Kariminia
  • Ung Vibol
  • Annette Sohn
  • Matthias Egger
  • Julia Bohlius
  • Kirk, Ole
  • Pediatric AIDS-Defining Cancer Project Working Group for IeDEA Southern Africa, TApHOD, and COHERE in EuroCoord

BACKGROUND:  The burden of Kaposi sarcoma (KS) in human immunodeficiency virus (HIV)-infected children and adolescents on combination antiretroviral therapy (cART) has not been compared globally.

METHODS:  We analyzed cohort data from the International Epidemiologic Databases to Evaluate AIDS and the Collaboration of Observational HIV Epidemiological Research in Europe. We included HIV-infected children aged <16 years at cART initiation from 1996 onward. We used Cox models to calculate hazard ratios (HRs), adjusted for region and origin, sex, cART start year, age, and HIV/AIDS stage at cART initiation.

RESULTS:  We included 24 991 children from eastern Africa, southern Africa, Europe and Asia; 26 developed KS after starting cART. Incidence rates per 100 000 person-years (PYs) were 86 in eastern Africa (95% confidence interval [CI], 55-133), 11 in southern Africa (95% CI, 4-35), and 81 (95% CI, 26-252) in children of sub-Saharan African (SSA) origin in Europe. The KS incidence rates were 0/100 000 PYs in children of non-SSA origin in Europe (95% CI, 0-50) and in Asia (95% CI, 0-27). KS risk was lower in girls than in boys (adjusted HR [aHR], 0.3; 95% CI, .1-.9) and increased with age (10-15 vs 0-4 years; aHR, 3.4; 95% CI, 1.2-10.1) and advanced HIV/AIDS stage (CDC stage C vs A/B; aHR, 2.4; 95% CI, .8-7.3) at cART initiation.

CONCLUSIONS:  HIV-infected children from SSA but not those from other regions, have a high risk of developing KS after cART initiation. Early cART initiation in these children might reduce KS risk.

TidsskriftClinical Infectious Diseases
Udgave nummer9
Sider (fra-til)1245-1253
Antal sider9
StatusUdgivet - 1 nov. 2016

ID: 174654339