Comparison of Kaposi Sarcoma Risk in Human Immunodeficiency Virus-Positive Adults Across 5 Continents: A Multiregional Multicohort Study
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Judd, Ali | Zangerle, Robert | Touloumi, Giota | Warszawski, Josiane | Meyer, Laurence | Dabis, François | Mary Krause, Murielle | Ghosn, Jade | Leport, Catherine | Wittkop, Linda | Reiss, Peter | Wit, Ferdinand | Prins, Maria | Bucher, Heiner | Gibb, Diana | Fätkenheuer, Gerd | Julia, del Amo | Obel, Niels | Thorne, Claire | Mocroft, Amanda | Kirk, Ole | Stephan, Christoph | Pérez-Hoyos, Santiago | Hamouda, Osamah | Bartmeyer, Barbara | Chkhartishvili, Nikoloz | Noguera-Julian, Antoni | Antinori, Andrea | D’arminio Monforte, Antonella | Brockmeyer, Norbert | Prieto, Luis | Rojo Conejo, Pablo | Soriano-Arandes, Antoni | Battegay, Manuel | Kouyos, Roger | Mussini, Cristina | Tookey, Pat | Casabona, Jordi | Miró, Jose, M | Castagna, Antonella | Konopnick, Deborah | Goetghebuer, Tessa | Sönnerborg, Anders | Quiros-Roldan, Eugenia | Sabin, Caroline | Teira, Ramon | Garrido, Myriam | Haerry, David | de Wit, Stéphane | Costagliola, Dominique | D’arminio-Monforte, Antonella | del Amo, Julia | Raben, Dorthe | Chêne, Geneviève | Pablo Rojo, Conejo | Barger, Diana | Schwimmer, Christine | Termote, Monique | Campbell, Maria | Frederiksen, Casper, M | Friis-Møller, Nina | Kjaer, Jesper | Salbøl Brandt, Rikke | Berenguer, Juan | Bohlius, Julia | Bouteloup, Vincent | Cozzi-Lepri, Alessandro | Davies, Mary-Anne | Dorrucci, Maria | Dunn, David | Egger, Matthias | Furrer, Hansjakob | Grabar, Sophie | Guiguet, Marguerite | Lambotte, Olivier | Leroy, Valériane | Lodi, Sara | Matheron, Sophie | Monge, Susana | Nakagawa, Fumiyo | Paredes, Roger | Phillips, Andrew | Puoti, Massimo | Rohner, Eliane | Schomaker, Michael | Smit, Colette | Sterne, Jonathan | Thiebaut, Rodolphe | Torti, Carlo | van der Valk, Marc | Tanser, Frank | Vinikoor, Michael | Macete, Eusebio | Wood, Robin | Stinson, Kathryn | Garone, Daniela | Fatti, Geoffrey | Giddy, Janet | Malisita, Kennedy | Eley, Brian | Fritz, Christiane | Hobbins, Michael | Kamenova, Kamelia | Fox, Matthew | Prozesky, Hans | Technau, Karl | Sawry, Shobna | Benson, Constance, A | Bosch, Ronald, J | Kirk, Gregory, D | Boswell, Stephen | Mayer, Kenneth, H | Grasso, Chris | Hogg, Robert, S | Richard Harrigan, P | Montaner, Julio, S G | Yip, Benita | Zhu, Julia | Salters, Kate | Gabler, Karyn | Buchacz, Kate | Brooks, John, T | Gebo, Kelly, A | Moore, Richard, D | Rodriguez, Benigno | Horberg, Michael, A | Silverberg, Michael, J | Thorne, Jennifer, E | Rabkin, Charles | Margolick, Joseph, B | Jacobson, Lisa, P | D’souza, Gypsyamber | Klein, Marina, B | Rourke, Sean, B | Rachlis, Anita, R | Cupido, Patrick | Hunter-Mellado, Robert, F | Mayor, Angel, M | John Gill, M | Deeks, Steven, G | Martin, Jeffrey, N | Patel, Pragna | Saag, Michael, S | Mugavero, Michael, J | Willig, James | Eron, Joseph, J | Napravnik, Sonia | Kitahata, Mari, M | Crane, Heidi, M | Drozd, Daniel, R | Sterling, Timothy, R | Haas, David | Rebeiro, Peter | Turner, Megan | Bebawy, Sally | Rogers, Ben | Justice, Amy, C | Dubrow, Robert | Fiellin, David | Gange, Stephen, J | Anastos, Kathryn | Althoff, Keri, N | Mckaig, Rosemary, G | Freeman, Aimee, M | Lent, Carol | van Rompaey, Stephen, E | Morton, Liz | Mcreynolds, Justin | Lober, William, B | Abraham, Alison, G | Lau, Bryan | Zhang, Jinbing | Jing, Jerry | Modur, Sharada | Wong, Cherise | Hogan, Brenna | Desir, Fidel | Liu, Bin | You, Bin | Cahn, Pedro | Cesar, Carina | Fink, Valeria | Sued, Omar | Dell’isola, Emanuel | Perez, Hector | Valiente, Jose | Yamamoto, Cleyton | Grinsztejn, Beatriz | Veloso, Valdilea | Luz, Paula | de Boni, Raquel | Cardoso Wagner, Sandra | Friedman, Ruth | Moreira, Ronaldo | Pinto, Jorge | Ferreira, Flavia | Maia, Marcelle | Célia de Menezes Succi, Regina | Maria Machado, Daisy | de Fátima Barbosa Gouvêa, Aida | Wolff, Marcelo | Cortes, Claudia | Fernanda Rodriguez, Maria | Allendes, Gladys | William Pape, Jean | Rouzier, Vanessa | Marcelin, Adias | Perodin, Christian | Tulio Luque, Marco | Padgett, Denis | Sierra Madero, Juan | Crabtree Ramirez, Brenda | Belaunzaran, Paco | Caro Vega, Yanink | Gotuzzo, Eduardo | Mejia, Fernando | Carriquiry, Gabriela | Mcgowan, Catherine, C | Shepherd, Bryan, E | Jayathilake, Karu | Person, Anna, K | Giganti, Mark | Castilho, Jessica | Duda, Stephany, N | Maruri, Fernanda | Vansell, Hilary | Ly, P, S | Khol, V | Zhang, F, J | Zhao, H, X | Han, N | Lee, M, P | Li, P, C K | Lam, W | Chan, Y, T | Kumarasamy, N | Saghayam, S | Ezhilarasi, C | Pujari, S | Joshi, K | Gaikwad, S | Chitalikar, A | Merati, T, P | Wirawan, D, N | Yuliana, F | Yunihastuti, E | Imran, D | Widhani, A | Tanuma, J | Oka, S | Nishijima, T | Na, S | Choi, J, Y | Kim, J, M | Sim, B, L H | Gani, Y, M | David, R | Kamarulzaman, A | Syed Omar, S, F | Ponnampalavanar, S | Azwa, I | Ditangco, R | Uy, E | Bantique, R | Wong, W, W | Ku, W, W | Wu, P, C | Ng, O, T | Lim, P, L | Lee, L, S | Ohnmar, P, S | Avihingsanon, A | Gatechompol, S | Phanuphak, P | Phadungphon, C | Kiertiburanakul, S | Sungkanuparph, S | Chumla, L | Sanmeema, N | Chaiwarith, R | Sirisanthana, T | Kotarathititum, W | Praparattanapan, J | Kantipong, P | Kambua, P | Ratanasuwan, W | Sriondee, R | Nguyen, K, V | Bui, H, V | Nguyen, D, T H | Cuong, D, D | An, N, V | Luan, N, T | Sohn, A, H | Ross, J, L | Petersen, B | Cooper, D, A | Law, M, G | Jiamsakul, A | Boettiger, D, C | Ellis, D | Bloch, M | Agrawal, S | Vincent, T | Allen, D | Smith, D | Rankin, A | Baker, D | Templeton, D, J | O’connor, C, C | Thackeray, O | Jackson, E | Mccallum, K | Ryder, N | Sweeney, G | Carr, A | Macrae, K | Hesse, K | Finlayson, R | Gupta, S | Langton-Lockton, J | Shakeshaft, J | Brown, K | Idle, S | Arvela, N | Varma, R | Lu, H | Couldwell, D | Eswarappa, S | Furner, V | Cabrera, G | Fernando, S | Cogle, A | Lawrence, C | Mulhall, B | Boyd, M | Petoumenos, K | Puhr, R | Huang, R | Han, A | Gunathilake, M | Payne, R | O’sullivan, M | Croydon, A | Russell, D | Cashman, C | Roberts, C | Sowden, D | Taing, K | Marshall, P | Orth, D | Youds, D | Rowling, D | Latch, N | Warzywoda, E | Dickson, B | Donohue, W | Edwards, S | Boyd, S | Roth, N, J | Lau, H | Read, T | Silvers, J | Zeng, W | Hoy, J | Watson, K | Bryant, M | Price, S | Woolley, I | Giles, M | Korman, T | Williams, J | Nolan, D | Allen, A | Guelfi, G | Mills, G | Wharry, C | Raymond, N | Bargh, K
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CCSD ; Oxford University Press (OUP) -
International audience.
Background. We compared Kaposi sarcoma (KS) risk in adults who started antiretroviral therapy (ART) across the Asia-Pacific, South Africa, Europe, Latin, and North America. Methods. We included cohort data of human immunodeficiency virus (HIV)-positive adults who started ART after 1995 within the framework of 2 large collaborations of observational HIV cohorts. We present incidence rates and adjusted hazard ratios (aHRs). Results. We included 208 140 patients from 57 countries. Over a period of 1 066 572 person-years, 2046 KS cases were diagnosed. KS incidence rates per 100 000 person-years were 52 in the Asia-Pacific and ranged between 180 and 280 in the other regions. KS risk was 5 times higher in South African women (aHR, 4.56; 95% confidence intervals [CI], 2.73-7.62) than in their European counterparts, and 2 times higher in South African men (2.21; 1.34-3.63). In Europe, Latin, and North America KS risk was 6 times higher in men who have sex with men (aHR, 5.95; 95% CI, 5.09-6.96) than in women. Comparing patients with current CD4 cell counts ≥700 cells/µL with those whose counts were <50 cells/µL, the KS risk was halved in South Africa (aHR, 0.53; 95% CI, .17-1.63) but reduced by ≥95% in other regions. Conclusions. Despite important ART-related declines in KS incidence, men and women in South Africa and men who have sex with men remain at increased KS risk, likely due to high human herpesvirus 8 coinfection rates. Early ART initiation and maintenance of high CD4 cell counts are essential to further reducing KS incidence worldwide, but additional measures might be needed, especially in Southern Africa.
