Wyss, Natascha, Zwahlen, Marcel ORCID: 0000-0002-6772-6346, Bohlius, Julia ORCID: 0000-0003-1955-1585, Clifford, Gary, Campbell, Maria, Chakraborty, Rana, Bonnet, Fabrice, Chene, Genevieve, Bani-Sadr, Firouze, Verbon, Annelies, Zangerle, Robert, Paparizos, Vassilios, Prins, Maria, Dronda, Fernando, Le Moing, Vincent ORCID: 0000-0002-9529-2792, Quiros-Roldan, Eugenia, Mussini, Cristina, Miro, Jose M., Meyer, Laurence, Vehreschild, Jorg J., Obel, Niels, Mocroft, Amanda, Sabin, Caroline ORCID: 0000-0001-5173-2760, Brockmeyer, Norbert, Boue, Francois, Spagnuolo, Vincenzo ORCID: 0000-0002-9656-7217, Hasse, Barbara, De Wit, Stephane, Roca, Bernardino and Egger, Matthias ORCID: 0000-0001-7462-5132 (2016). Changing Incidence and Risk Factors for Kaposi Sarcoma by Time Since Starting Antiretroviral Therapy: Collaborative Analysis of 21 European Cohort Studies. Clin. Infect. Dis., 63 (10). S. 1373 - 1380. CARY: OXFORD UNIV PRESS INC. ISSN 1537-6591

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Abstract

Background. Kaposi sarcoma (KS) remains a frequent cancer in human immunodeficiency virus (HIV)-positive patients starting combination antiretroviral therapy (cART). We examined incidence rates and risk factors for developing KS in different periods after starting cART in patients from European observational HIV cohorts. Methods. We included HIV-positive adults starting cART after 1 January 1996. We analyzed incidence rates and risk factors for developing KS up to 90 and 180 days and 1, 2, 5, and 8 years after cART start and fitted univariable and ultivariable Cox regression models. Results. We included 109 461 patients from 21 prospective clinical cohorts in Europe with 916 incident KS cases. The incidence rate per 100 000 person-years was highest 6 months after starting cART, at 953 (95% confidence interval, 866-1048), declining to 82 (68-100) after 5-8 years. In multivariable analyses adjusted for exposure group, origin, age, type of first-line regimen, and calendar year, low current CD4 cell counts increased the risk of developing KS throughout all observation periods after cART initiation. Lack of viral control was not associated with the hazard of developing KS in the first year after cART initiation, but was over time since starting cART increasingly positively associated (P<.001 for interaction). Conclusion. In patients initiating cART, both incidence and risk factors for KS change with time since starting cART. Whereas soon after starting cART low CD4 cell count is the dominant risk factor, detectable HIV-1 RNA viral load becomes an increasingly important risk factor in patients who started cART several years earlier, independently of immunodeficiency.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Wyss, NataschaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zwahlen, MarcelUNSPECIFIEDorcid.org/0000-0002-6772-6346UNSPECIFIED
Bohlius, JuliaUNSPECIFIEDorcid.org/0000-0003-1955-1585UNSPECIFIED
Clifford, GaryUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Campbell, MariaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chakraborty, RanaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bonnet, FabriceUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chene, GenevieveUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bani-Sadr, FirouzeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Verbon, AnneliesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zangerle, RobertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Paparizos, VassiliosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Prins, MariaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dronda, FernandoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Le Moing, VincentUNSPECIFIEDorcid.org/0000-0002-9529-2792UNSPECIFIED
Quiros-Roldan, EugeniaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mussini, CristinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Miro, Jose M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Meyer, LaurenceUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vehreschild, Jorg J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Obel, NielsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mocroft, AmandaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sabin, CarolineUNSPECIFIEDorcid.org/0000-0001-5173-2760UNSPECIFIED
Brockmeyer, NorbertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Boue, FrancoisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Spagnuolo, VincenzoUNSPECIFIEDorcid.org/0000-0002-9656-7217UNSPECIFIED
Hasse, BarbaraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
De Wit, StephaneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Roca, BernardinoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Egger, MatthiasUNSPECIFIEDorcid.org/0000-0001-7462-5132UNSPECIFIED
URN: urn:nbn:de:hbz:38-255686
DOI: 10.1093/cid/ciw562
Journal or Publication Title: Clin. Infect. Dis.
Volume: 63
Number: 10
Page Range: S. 1373 - 1380
Date: 2016
Publisher: OXFORD UNIV PRESS INC
Place of Publication: CARY
ISSN: 1537-6591
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
AIDS-DEFINING CANCERS; HIV-INFECTED PATIENTS; IMMUNODEFICIENCY; REACTIVATION; REPLICATION; HERPESVIRUS; INITIATION; AFRICA; FRANCE; ADULTSMultiple languages
Immunology; Infectious Diseases; MicrobiologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/25568

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