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 (ISPM) |
UniBE Contributor: |
Rohner, Eliane, Schmidlin, Kurt, Zwahlen, Marcel, Egger, Matthias, Bohlius, Julia Friederike |
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: |
02 Mar 2023 23:28 |
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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