Comparison of Kaposi Sarcoma Risk in Human Immunodeficiency Virus-Positive Adults Across 5 Continents: A Multiregional Multicohort Study

作者：The AIDS-defining Cancer Project Working Group for IeDEA and COHERE in EuroCoord, Ali Judd, Robert Zangerle, Giota Touloumi, Josiane Warszawski, Laurence Meyer, François Dabis, Murielle Mary Krause, Jade Ghosn, Catherine Leport, Linda Wittkop, Peter Reiss, Ferdinand Wit, M. Prins, Heiner Bucher, Diana M. Gibb, Gerd Fätkenheuer, Del Amo Julia, Niels Obel, Claire Thorne, Amanda Mocroft, Ole Kirk, Christoph Stephan, Santiago Pérez‐Hoyos, Osamah Hamouda, Barbara Bartmeyer, Nikoloz Chkhartishvili, Antoni Noguera‐Julián, Andrea Antinori, Antonella d’Arminio Monforte, Norbert H. Brockmeyer, Luis Prieto, Pablo Rojo Conejo, Antoni Soriano‐Arandes, Manuel Battegay, Roger D. Kouyos, Cristina Mussini, Pat Tookey, Jordi Casabona, Jose M Miró, Antonella Castagna, Deborah Konopnick, Tessa Goetghebuer, Anders Sönnerborg, Eugenia Quirós-Roldán, Caroline Sabin, Ramón Teira, Myriam Garrido, David Haerry, Stéphane de Wit, Jose M Miró, Dominique Costagliola, Antonella d’Arminio Monforte, Antonella Castagna, Julia del Amo, Amanda Mocroft, Dorthe Raben, Geneviève Chêne, Ali Judd, Conejo Pablo Rojo, Diana Barger, Christine Schwimmer, Monique Termote, Linda Wittkop, Maria Campbell, Casper Møller Frederiksen, Nina Friis‐Møller, Jesper Kjær, Dorthe Raben, Rikke Brandt, Juan Berenguer, Julia Bohlius, Vincent Bouteloup, Heiner Bucher, Alessandro Cozzi‐Lepri, François Dabis, Antonella d’Arminio Monforte, Mary-Anne Davies, Julia del Amo, Maria Dorrucci, David Dunn, Matthias Egger, Hansjakob Furrer, Sophie Grabar, Marguerite Guiguet, Ali Judd, Ole Kirk, Olivier Lambotte, Valériane Leroy, Sara Lodi, Sophie Matheron, Laurence Meyer, Jose M Miró, Amanda Mocroft, Susana Monge, Fumiyo Nakagawa, Roger Paredes, Andrew W. Phillips, Massimo Puoti, Eliane Rohner, Michael Schomaker, Colette Smit, Jonathan A C Sterne, Rodolphe Thiébaut, Claire Thorne, Carlo Torti, Marc van der Valk, Linda Wittkop, Frank Tanser, Michael J. Vinikoor, Eusébio Macete, Robin Wood, Kathryn Stinson, Daniela Garone, Geoffrey Fatti, Janet Giddy, Kennedy Malisita, Brian Eley, Christiane Fritz, Michael Hobbins, Kamelia Kamenova, Matthew P. Fox, Hans Prozesky, Karl‐Günter Technau, Shobna Sawry, Constance A. Benson, Ronald J. Bosch, Gregory D. Kirk, Stephen Boswell, Kenneth H. Mayer, Chris Grasso, Robert S. Hogg, P. Richard Harrigan, Joan Montaner, Benita Yip, Julia Zhu, Kate Salters, Karyn Gabler, Kate Buchacz, John T. Brooks, Kelly A. Gebo, Richard D Moore, Richard D Moore, Benigno Rodríguez, Michael A. Horberg, Michael J. Silverberg, Jennifer E. Thorne, Charles S. Rabkin, Joseph B. Margolick, Lisa P. Jacobson, Gypsyamber DʼSouza, Marina B. Klein, Sean B. Rourke, Anita Rachlis, Patrick Cupido, Robert F. Hunter-Mellado, Ángel M. Mayor, M. John Gill, Steven G. Deeks, Jeffrey N. Martin, Pragna Patel, John T. Brooks, Michael S Saag, Michael J. Mugavero, James H. Willig, Joseph J. Eron, Sonia Napravnik, Mari M. Kitahata, Heidi M Crane, Daniel R Drozd, Timothy R. Sterling, David M. Haas, Peter F. Rebeiro, Megan C. Turner, Sally Bebawy, Ben Rogers, Amy C. Justice, Robert Dubrow, David A. Fiellin, Stephen J. Gange, Kathryn Anastos, Richard D Moore, Michael S Saag, Stephen J. Gange, Mari M. Kitahata, Keri N. Althoff, Michael A. Horberg, Marina B. Klein, Rosemary G. McKaig, Aimee M Freeman, Richard D Moore, Aimee M Freeman, Carol Lent, Mari M. Kitahata, Stephen E. Van Rompaey, Heidi M Crane, Daniel R Drozd, Liz Morton, Justin McReynolds, William B. Lober, Stephen J. Gange, Keri N. Althoff, Alison G. Abraham, Bryan Lau, Jinbing Zhang, Jerry Jing, Sharada P. Modur, Cherise Wong, Brenna Hogan, Fidel Desir, Bin Liu, Bin You, Pedro Cahn, Carina César, Valeria Fink, Omar Sued, Emanuel Dell’Isola, Hector Pérez, José A. Ruipérez‐Valiente, Cleyton Yamamoto, Beatriz Grinsztejn, Valdiléa G. Veloso, Paula M. Luz, Raquel B. De Boni, Sandra Cardoso Wagner, Ruth Khalili Friedman, Ronaldo I. Moreira, Jorge Pinto, Flávia Regina Ferreira, Marcelle Marie Martins Maia, Regina Célia de Menezes Succi, Daisy Maria Machado, Aïda de Fátima Barbosa Gouvea, Marcelo Wolff, Claudia P. Cortés, Maria Fernanda Rodriguez, Gladys Allendes, Jean W. Pape, Vanessa Rouzier, Adias Marcelin, Christian Perodin, Marco Tulio Luque, Denis Padgett, Juan Sierra Madero, Brenda Crabtree‐Ramírez, Pablo F. Belaunzarán-Zamudio, Yanink Caro Vega, Eduardo Gotuzzo, Fernando Mejía, Gabriela Carriquiry, Catherine C. McGowan, Bryan E. Shepherd, Timothy R. Sterling, Karu Jayathilake, Anna K. Person, Peter F. Rebeiro, Mark J Giganti, Jessica L. Castilho, Stephany N. Duda, Fernanda Maruri, Hilary Vansell, Penh Sun Ly, V. Khol, FJ Zhang, Hong Zhao, Ning Han, MP Lee, P C K Li, W Lam, Y.T. Chan, N. Kumarasamy, Suneeta Saghayam, C Ezhilarasi, Sanjay Pujari, Kedar Joshi, S Gaikwad, Abhishek Chitalikar, Tuti Parwati Merati, Dewa Nyoman Wirawan, Fina Yuliana, Evy Yunihastuti, Darma Imran, Alvina Widhani, Junko Tanuma, Shiro Oka, Takeshi Nishijima, Saliba Na, Jun Yong Choi, Jeong‐Min Kim, BLH Sim, Yasmin Gani, R David, Adeeba Kamarulzaman, Shahed Omar, Sasheela Ponnampalavanar, Iskandar Azwa, Rossana Ditangco, Elenore Judy B. Uy, R. Bantique, W W Wong, Wen-Wei Ku, Pingsheng Wu, Oon Tek Ng, P.L. Lim, Lee Ls, P S Ohnmar, Anchalee Avihingsanon, Sivaporn Gatechompol, Praphan Phanuphak, Chowalit Phadungphon, Sasisopin Kiertiburanakul, Somnuek Sungkanuparph, L. Chumla, N. Sanmeema, Romanee Chaiwarith, Thira Sirisanthana, Wilai Kotarathititum, J Praparattanapan, Pacharee Kantipong, P. Kambua, Winai Ratanasuwan, R. Sriondee, Kinh Van Nguyen, H V Bui, D T H Nguyen, D.T. Nguyen, D D Cuong, Ngo Van An, Ning Luan, A Sohn, J.L. Ross, B. Petersen, David A. Cooper, Matthew Law, Awachana Jiamsakul, David Boettiger, Deborah A. Ellis, Mark Bloch, Sanjay Agrawal, Tim Vincent, Debra Allen, Don Smith, Alastair J. Rankin, David Baker, David J. Templeton, Catherine OʼConnor, O Thackeray, Elizabeth Jackson, Kerry McCallum, Nathan Ryder, Gary Sweeney, David A. Cooper, Andrew Carr, K D MacRae, Karl Hesse, Robert Finlayson, Surbhi Gupta, Julian Langton‐Lockton, J. R. Shakeshaft, Katherine Brown, Salwa Abdullahi Idle, N Arvela, Rick Varma, Haojie Lu, Deborah L. Couldwell, S. Eswarappa, Don Smith, Virginia Furner, Don Smith, Gustavo Cabrera, Shannon M. Fernando, Aaron Cogle, Christopher Lawrence, Brian P. Mulhall, Mark Boyd, Matthew Law, Kathy Petoumenos, Rainer Puhr, Robin Huang, Ahram Han, Manoji Gunathilake, Rupert Payne, M.J. O’Sullivan, Abigail Croydon, Darren Russell, C. Cashman, Claire T. Roberts, David Sowden, Kuong Taing, Patricia A. Marshall, David N. Orth, D Youds, Diane Rowling, Ngaire Latch, E. Warzywoda, Bridget Dickson, William A. Donohue, Richard E. Moore, Simon Edwards, Sophie Boyd, N Roth, H. Lau, T Read, J Silvers, Weihua Zeng, Jennifer Hoy, Karol E. Watson, Melanie Bryant, Susanna Price, Ian Woolley, M Giles, Tony M. Korman, John Williams, D. Nolan, Andrew M. Allen, Gabriella Guelfi, Gordon B. Mills, C Wharry, Nigel Raymond, Kelly Bargh, David J. Templeton, M Giles, Katherine Brown, Jennifer Hoy · 发表于：Clinical Infectious Diseases · 年份：2017 · DOI：10.1093/cid/cix480 · 被引用次数：63 · 研究领域：Viral-associated cancers and disorders、CNS Lymphoma Diagnosis and Treatment、Lymphoma Diagnosis and Treatment

BACKGROUND: We compared Kaposi sarcoma (KS) risk in adults who started antiretroviral therapy (ART) across the Asia-Pacific, South Africa, Europe, Latin, and North America. METHODS: We included cohort data of human immunodeficiency virus (HIV)-positive adults who started ART after 1995 within the framework of 2 large collaborations of observational HIV cohorts. We present incidence rates and adjusted hazard ratios (aHRs). RESULTS: We included 208140 patients from 57 countries. Over a period of 1066572 person-years, 2046 KS cases were diagnosed. KS incidence rates per 100000 person-years were 52 in the Asia-Pacific and ranged between 180 and 280 in the other regions. KS risk was 5 times higher in South African women (aHR, 4.56; 95% confidence intervals [CI], 2.73-7.62) than in their European counterparts, and 2 times higher in South African men (2.21; 1.34-3.63). In Europe, Latin, and North America KS risk was 6 times higher in men who have sex with men (aHR, 5.95; 95% CI, 5.09-6.96) than in women. Comparing patients with current CD4 cell counts ≥700 cells/µL with those whose counts were <50 cells/µL, the KS risk was halved in South Africa (aHR, 0.53; 95% CI, .17-1.63) but reduced by ≥95% in other regions. CONCLUSIONS: Despite important ART-related declines in KS incidence, men and women in South Africa and men who have sex with men remain at increased KS risk, likely due to high human herpesvirus 8 coinfection rates. Early ART initiation and maintenance of high CD4 cell count...