Article Text
Abstract
Background The aim of this study is the acquisition and description of patients with HIV-associated Kaposi-sarcoma (KS) from the cohort database of the competence network for HIV/AIDS.
Patients and Methods Data from patients with diagnosis of KS from 9 centres of the competence network for HIV/AIDS were evaluated. The baseline characteristics at the time of the initial KS diagnosis were described. Recurrence and survival probabilities were estimated by means of Kaplan-Meier curves. The influence factors for survival were analysed with multiple Cox regression models. As potential risk factors for the mortality risk the CD4- and CD8 cell count, HIV-viral load value, antiretroviral therapy (ART), chemotherapy and the patient’s age were evaluated.
Results In the period of 1987–2011 KS was diagnosed in 222 study participants, 97.7% were men and 2.3% women. The most common HIV-transmission risk was MSM (88.3%). The median age was 38.5 years (min. 23.4; max. 76.8). 70.5% of the patients showed exclusively cutaneus presentation. The median value of HIV viral load was 37,000 copies per ml at the initial diagnosis of KS. 55.5% of the patients had a CD4 cell count under 200/µl. A KS therapy was documented for 198 patients. The 222 study participants were clustered according their therapies; ART only and ART in combination with other treatments, e.g. liposomal doxorubicin or other chemotherapeutic regimen, local excision, radiation and/or interferon-alpha. It was shown that about 80% of the patients had no recurrence after the therapies and 18 patients died. The 5 and 10-year survival probabilities were 96.8% and 91.3%. In addition it was shown by the Cox-model that patients with higher CD4 and patients without ART before KS diagnosis had a significant lower mortality risk.
Conclusion A low CD4 cell count at KS diagnosis is an important predictor for mortality.
- HIV
- Kaposi’s sarcoma
- Patient profile