Kaposi Sarcoma Risk in HIV-Infected Children and Adolescents on Combination Antiretroviral Therapy From Sub-Saharan Africa, Europe, and Asia

被引：16

作者：

Tanser, Frank ^{[2
]}

Vinikoor, Michael ^{[3
]}

Macete, Eusebio ^{[4
]}

Wood, Robin ^{[5
,6
]}

Stinson, Kathryn ^{[7
,8
]}

Garone, Daniela ^{[7
,8
]}

Fatti, Geoffrey ^{[9
]}

Phiri, Sam ^{[10
]}

Giddy, Janet ^{[11
]}

Chimbetete, Cleophas ^{[12
]}

Malisita, Kennedy ^{[13
,14
,15
]}

Eley, Brian

Fritz, Christiane ^{[16
]}

Hobbins, Michael ^{[17
]}

Kamenova, Kamelia ^{[18
]}

Fox, Matthew ^{[19
]}

Prozesky, Hans ^{[20
]}

Technau, Karl ^{[21
]}

Sawry, Shobna ^{[22
]}

Zangerle, Robert ^{[23
]}

Touloumi, Giota ^{[24
]}

Warszawski, Josiane ^{[25
]}

Meyer, LauRence ^{[26
]}

Dabis, Francois ^{[27
]}

Krause, Murielle Mary ^{[28
]}

Ghosn, Jade ^{[29
]}

Leport, Catherine ^{[30
]}

Wittkop, Linda ^{[31
]}

Reiss, Peter ^{[32
]}

Wit, Ferdinand ^{[32
]}

Prins, Maria ^{[33
]}

Bucher, Heiner ^{[33
]}

Sabin, Caroline ^{[34
]}

Gibb, Diana ^{[35
]}

Faetkenheuer, Gerd

Del Amo, Julia ^{[36
]}

Obel, Niels ^{[37
]}

Thorne, Claire ^{[38
]}

Mocroft, Amanda ^{[39
]}

Kirk, Ole ^{[39
]}

Stephan, Christoph

Perez-Hoyos, Santiago ^{[40
]}

Hamouda, Osamah ^{[41
]}

Bartmeyer, Barbara ^{[41
]}

Chkhartishvili, Nikoloz ^{[42
]}

Noguera-Julian, Antoni ^{[43
]}

Antinori, Andrea ^{[44
]}

Monforte, Antonella d'Arminio ^{[45
]}

Brockmeyer, Norbert ^{[46
]}

Prieto, Luis ^{[47
]}

机构：

[1] Univ Bern, Inst Social & Prevent Med, Finkenhubelweg 11, CH-3012 Bern, Switzerland

[2] Univ Kwazulu Natal, Africa Ctr Hlth & Populat Studies, Somkhele, South Africa

[3] Ctr Infect Dis Res Zambia, Lusaka, Zambia

[4] Ctr Invest Saude Manhica, Manhica, Mozambique

[5] Desmond Tutu HIV Ctr, Gugulethu Clin, Cape Town, South Africa

[6] Desmond Tutu HIV Ctr, Masiphumelele Clin, Cape Town, South Africa

[7] Khayelitsha ART Programme, Cape Town, South Africa

[8] Med Sans Frontieres, Cape Town, South Africa

[9] Kheth Impilo Programme, Cape Town, South Africa

[10] Lighthouse Trust Clin, Lilongwe, Malawi

[11] McCord Hosp, Durban, South Africa

[12] Newlands Clin, Harare, Zimbabwe

[13] Queen Elizabeth Hosp, Blantyre, Malawi

[14] Univ Cape Town, Red Cross War Mem Childrens Hosp, Cape Town, South Africa

[15] Univ Cape Town, Dept Paediat & Child Hlth, Cape Town, South Africa

[16] SolidarMed SMART Programme, Maseru, Lesotho

[17] SolidarMed SMART Programme, Pemba Region, Mozambique

[18] SolidarMed SMART Programme, Masvingo, Zimbabwe

[19] Themba Lethu Clin, Johannesburg, South Africa

[20] Tygerberg Acad Hosp, Cape Town, South Africa

[21] Rahima Moosa Mother & Child Hosp, Empilweni Clin, Johannesburg, South Africa

[22] Chris Hani Baragwanath Hosp, Harriet Shezi Childrens Clin, Soweto, South Africa

[23] AHIV COS, Soweto, South Africa

[24] AMACS, Houston, TX USA

[25] ANRS CO1 EPF ANRS CO11 OBSERV EPF, Houston, TX USA

[26] ANRS CO2 SEROCO, Houston, TX USA

[27] ANRS CO3 AQUITAINE, Houston, TX USA

[28] ANRS CO4 FHDH, Houston, TX USA

[29] ANRS CO6 PRIMO, Houston, TX USA

[30] ANRS CO8 COPILOTE, Houston, TX USA

[31] ANRS CO13 HEP AVIH, Houston, TX USA

[32] ATHENA, Houston, TX USA

[33] CASCADE, Fairview, OR USA

[34] UK CHIC, London, England

[35] CHIPS, London, England

[36] CoRIS, Paris, France

[37] Danish HIV Cohort, Paris, France

[38] ECS, Paris, France

[39] EuroSIDA, Paris, France

[40] GEMES Haemo, Paris, France

[41] German ClinSurv, Berlin, Germany

[42] Georgian Natl HIV AIDS, Berlin, Germany

[43] CORISPE Cat, Catalonia, Spain

[44] ICC, Catalonia, Spain

[45] ICONA, Catalonia, Spain

[46] KOMPNET, Torun, Poland

[47] Madrid PMTCT Cohort, Torun, Poland

[48] CORISPES Madrid, Madrid, Spain

[49] NENEXP, Madrid, Spain

[50] SHCS, Madrid, Spain

来源：

CLINICAL INFECTIOUS DISEASES | 2016年 / 63卷 / 09期

基金：

美国国家卫生研究院; 瑞士国家科学基金会;

关键词：

Kaposi sarcoma; HIV; children; antiretroviral therapy; cohort study; COHORT PROFILE; CANCER; AIDS; HERPESVIRUS; TERM; IMMUNODEFICIENCY; SEROPREVALENCE; MALIGNANCIES;

D O I：

10.1093/cid/ciw519

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. The burden of Kaposi sarcoma (KS) in human immunodeficiency virus (HIV)-infected children and adolescents on combination antiretroviral therapy (cART) has not been compared globally. Methods. We analyzed cohort data from the International Epidemiologic Databases to Evaluate AIDS and the Collaboration of Observational HIV Epidemiological Research in Europe. We included HIV-infected children aged <16 years at cART initiation from 1996 onward. We used Cox models to calculate hazard ratios (HRs), adjusted for region and origin, sex, cART start year, age, and HIV/AIDS stage at cART initiation. Results. We included 24 991 children from eastern Africa, southern Africa, Europe and Asia; 26 developed KS after starting cART. Incidence rates per 100 000 person-years (PYs) were 86 in eastern Africa (95% confidence interval [CI], 55-133), 11 in southern Africa (95% CI, 4-35), and 81 (95% CI, 26-252) in children of sub-Saharan African (SSA) origin in Europe. The KS incidence rates were 0/100 000 PYs in children of non-SSA origin in Europe (95% CI, 0-50) and in Asia (95% CI, 0-27). KS risk was lower in girls than in boys (adjusted HR [aHR], 0.3; 95% CI, .1-. 9) and increased with age (10-15 vs 0-4 years; aHR, 3.4; 95% CI, 1.2-10.1) and advanced HIV/AIDS stage (CDC stage C vs A/B; aHR, 2.4; 95% CI,.8-7.3) at cART initiation. Conclusions. HIV-infected children from SSA but not those from other regions, have a high risk of developing KS after cART initiation. Early cART initiation in these children might reduce KS risk.

引用

页码：1245 / 1253

页数：9