Thirlwell C, Lafuente A, Stebbing J, Nelson M, Gazzard B, Bower M; IAS Conference on HIV Pathogenesis and Treatment (2nd : 2003 : Paris, France).
Antivir Ther. 2003; 8 (Suppl.1): abstract no. 933.
Chelsea and Westminster Hospital, London, UK
BACKGROUND: With the introduction of HAART there has been a decline in the incidence and an improvement in outcome of HIV associated Kaposi's sarcoma (KS). METHODS: The clinicopathological details and treatments for all patients with newly diagnosed KS was reviewed. RESULTS: Seventy patients (67 male) have been diagnosed over 2 years since January 2000. The mean age at KS diagnosis is 42 years (range 23-66) and the median interval between HIV diagnosis and developing KS is 1.3 years (range 0-17). Nine patients had visceral KS at presentation and the ACTG stages were T0I0=42%, T1I0=30%, T0I1=12% and T1I1=15%. At the time of KS diagnosis the median CD4 cell count was 212/mm3 (range 5-638) and 20 patients were on HAART of whom 11 had undetectable HIV-1 viral loads. Of the 50 patients not on HAART at the time of KS diagnosis, 35 were treated with HAART alone. For these patients the 1 year (additional) treatment-free survival is 91% and only five have required systemic chemotherapy or radiotherapy for KS. Overall for the whole cohort, four patients have died (two from PCP and two from Castleman's disease). The 2-year overall survival is 93% (95% CI; 86-100%). CONCLUSIONS: The majority of patients who present with KS in the third millennium are either HAART-naive or are failing HAART therapy. The mortality associated with KS is low and even when visceral disease is present this is not an adverse prognostic variable for survival. The high frequency of fatal Castleman's disease in this cohort reflects the well-known association with HHV-8 and the lack of effective therapies for HIV-associated Castleman's disease.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Antiretroviral Therapy, Highly Active
- CD4 Lymphocyte Count
- Giant Lymph Node Hyperplasia
- HIV Infections
- HIV Seropositivity
- Herpesvirus 8, Human
- Humans
- Incidence
- Male
- Sarcoma, Kaposi
Other ID:
UI: 102263211
From Meeting Abstracts