The widespread introduction of effective antiretrovirals (ART) to control HIV dramatically decreased the burden of AIDS-related Kaposi Sarcoma (KS). However, KS remains the second most frequent tumor in patients infected with HIV in the world, being the most common cancer in sub-Saharan Africa. The clinical course of KS can range from an indolent state to a severe, progressive disease leading to significant morbidity and mortality. ART is essential for HIV-infected KS patients, but despite ART, up to a third of KS patients have disease recurrence or do not respond to ART alone. Moreover, KS also develops in HIV patients despite ART, i.e., in patients with no detectable HIV load and nearnormal CD4 levels. Our aim was to define trends in incidence/prevalence of KS, outcome and associated factors in a large Italian cohort of HIVinfected patients. We included naïve HIV-infected individuals (PLHIV) enrolled in the ICONA cohort over 1997-2019. Prevalent cases were PLHIV with a diagnosis of KS prior and up to 30 days after enrolment. Incident cases were defined as new KS diagnoses occurring after ART initiation. Patients’ characteristics at the date of enrolment were compared by prevalent KS status and associations identified by logistic regression modelling. In the subset of people KS-free at enrolment, standard Kaplan- Meier curves were used to model time from ART initiation to development of KS and a Cox regression model to identify factors associated with this outcome. A similar analysis was performed in PLHIV with prevalent KS to identify factors associated with their risk of KS relapse or death after ART (clinical failure).

Impact of universal art access on Kaposi Sarcoma: results from the ICONA Cohort

G. Nunnari;G. F. Pellicanò.
2020

Abstract

The widespread introduction of effective antiretrovirals (ART) to control HIV dramatically decreased the burden of AIDS-related Kaposi Sarcoma (KS). However, KS remains the second most frequent tumor in patients infected with HIV in the world, being the most common cancer in sub-Saharan Africa. The clinical course of KS can range from an indolent state to a severe, progressive disease leading to significant morbidity and mortality. ART is essential for HIV-infected KS patients, but despite ART, up to a third of KS patients have disease recurrence or do not respond to ART alone. Moreover, KS also develops in HIV patients despite ART, i.e., in patients with no detectable HIV load and nearnormal CD4 levels. Our aim was to define trends in incidence/prevalence of KS, outcome and associated factors in a large Italian cohort of HIVinfected patients. We included naïve HIV-infected individuals (PLHIV) enrolled in the ICONA cohort over 1997-2019. Prevalent cases were PLHIV with a diagnosis of KS prior and up to 30 days after enrolment. Incident cases were defined as new KS diagnoses occurring after ART initiation. Patients’ characteristics at the date of enrolment were compared by prevalent KS status and associations identified by logistic regression modelling. In the subset of people KS-free at enrolment, standard Kaplan- Meier curves were used to model time from ART initiation to development of KS and a Cox regression model to identify factors associated with this outcome. A similar analysis was performed in PLHIV with prevalent KS to identify factors associated with their risk of KS relapse or death after ART (clinical failure).
978-1-7320053-3-4
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11570/3151809
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