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

Rohner, Eliane; Schmidlin, Kurt; Zwahlen, Marcel; Chakraborty, Rana; Clifford, Gary; Obel, Niels; Grabar, Sophie; Verbon, Annelies; Noguera-Julian, Antoni; Judd, Ali; Collins, Intira Jeannie; Rojo, Pablo; Brockmeyer, Norbert; Campbell, Maria; Chêne, Geneviève; Prozesky, Hans; Eley, Brian; Stefan, Christina; Davidson, Alan; Chimbetete, Cleophas; ... (2016). Kaposi Sarcoma Risk in HIV-Infected Children and Adolescents on Combination Antiretroviral Therapy From Sub-Saharan Africa, Europe, and Asia. Clinical infectious diseases, 63(9), pp. 1245-53. Oxford University Press 10.1093/cid/ciw519

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine

UniBE Contributor:

Rohner, Eliane; Schmidlin, Kurt; Zwahlen, Marcel; Egger, Matthias and Bohlius, Julia

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1058-4838

Publisher:

Oxford University Press

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

06 Sep 2016 13:57

Last Modified:

08 Sep 2017 11:54

Publisher DOI:

10.1093/cid/ciw519

PubMed ID:

27578823

Uncontrolled Keywords:

HIV; Kaposi sarcoma; antiretroviral therapy; children; cohort study

BORIS DOI:

10.7892/boris.87844

URI:

https://boris.unibe.ch/id/eprint/87844

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