Blair JM, Kovacs A, Beall G, Beer V, Sorvillo F, Kerndt P; National Conference on Women & HIV.
Natl Conf Women HIV Natl Conf Women HIV Innov Care Policy Prev 1997 Los Angel Calif. 1997 May 4-7; 109 (abstract no. 106.4).
Los Angeles County Department of Health Services, HIV Epidemiology Program, Los Angeles, CA.
Objectives: To describe the incidence and characteristics of women with acquired immunodeficiency syndrome (AIDS)-related Kaposi's sarcoma (KS) in the Los Angeles site of the Adult Spectrum of Disease study (ASD), a database of the Centers for Disease Control and Prevention (CDC). ASD is a medical records cohort study that prospectively examines the natural history of clinical syndromes among human immunodeficiency virus (HIV)-infected adults and adolescents 13 years of age or older. Methods: Records were reviewed and collected from May 1989 to December 1996 to identify women with HIV infection and KS who received care at one of the participating facilities. Bivariate analysis was used to describe female patients presenting with KS. Time from KS diagnosis to death was examined using Kaplan-Meier product-limit survival analyses. Median survival in months was calculated using the Statistical Analysis System (SAS). A Cox proportional hazards model was constructed to evaluate factors independently associated with KS in women. Results: A total of 833 women with HIV were followed, 15 (1.8%) of whom were diagnosed with KS. Six (40%) of the patients were black, 5 (33%) Latino, and 4 (27%) white. The crude incidence rate of KS was 1.0 per 100 person-years. Median age at KS diagnosis was 34 years. Thirteen (86%) of patients reported having sex with men; of these, 3 (20%) reported having sex with a bisexual male. The majority of patients (13) were from the United States, while two patients (13%) were from South America and Africa. Information regarding clinical characteristics such as CD4+ lymphocyte count at KS diagnosis was available for 10 patients. Median CD4+ count at KS diagnosis was 13 cells/mm(3). Six women (40%) had prior AIDS-defining illnesses; among these, Pneumocystis carinii pneumonia (PCP) was the most common diagnosis, occurring in 4 (66%) of the 6 women. The median crude survival time among women with KS was 8.9 months, compared to 23.3 months observed among men. Only two women (13%) received chemotherapy for KS. Conclusions: Women with Kaposi's sarcoma may have a highly aggressive disease course due to the fact that they are diagnosed at relatively low CD4+ counts. Because Kaposi's sarcoma is such a rare neoplastic complication in women with HIV, decreased survival for women with KS may reflect a delay in seeking appropriate medical care. Future studies should involve an examination of the KS disease process in women, and determining additional risk factors that contribute to the development of KS, such as the presence of human herpesvirus 8.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Adolescent
- Adult
- Africa
- CD4 Lymphocyte Count
- Cohort Studies
- Disease Progression
- Female
- HIV Seropositivity
- Humans
- Incidence
- Los Angeles
- Male
- Proportional Hazards Models
- Risk Factors
- Sarcoma, Kaposi
- South America
- Survival Analysis
- United States
Other ID:
UI: 102225799
From Meeting Abstracts