Incidence of acquired immunodeficiency syndrome (AIDS)-related Kaposi's sarcoma in the Aquitaine Cohort, France, 1988-1996

Objective To assess secular trends of the incidence of Kaposi's sarcoma (KS) between 1998 and 1996 in the Aquitaine Cohort of human immunodeficiency virus type 1 (HIV-1)-infected subjects (southwestern France). Methods Adults of both sexes of all HIV-transmission categories were included. We distinguished between incident and prevalent KS and in case of multiple acquired immunodeficiency syndrome (AIDS) defining illnesses between initial or subsequent KS. Only incident KS were considered for annual incidence rate calculation. Results Overall, 21.2% (356/1678) of homosexuals and 1.9% (58/3030) of the other patients were diagnosed with KS over time. Although there was a sharp decrease in 1996 for initial KS, the annual incidence rate of KS was stable over time in the overall cohort as well as in homosexuals (4.3% per year on the average for KS as an initial AIDS-defining illness and 2.1% per year for subsequent KS in homosexuals). The median CD4+ cell count at the time of diagnosis of KS was 56 per mm(3) (78 for initial KS, 14 for subsequent KS), with no significant variation over time. Conclusion In the Aquitaine Cohort, the annual incidence of KS has remained stable between 1988 and 1995 with a recent decline in 1996, only for initial KS, while case management of HIV-infected subjects changed drastically.