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Volume 42, Number 3, June 2009

Kaposi’s sarcoma in patients with human immunodeficiency virus infection in Taiwan


Chi-Ying Lin, Mao-Yuan Chen, Szu-Min Hsieh, Wang-Huei Sheng, Hsin-Yun Sun, Yi-Chun Lo, Chien-Ching Hung, Shan-Chwen Chang
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

Received: May 1, 2008    Revised: May 20, 2008    Accepted: June 6, 2008   

 

Corresponding author:

 Dr. Chien-Ching Hung, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan. E-mail: Dr. Chien-Ching Hung This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

 



 

Background and purpose: 

Kaposi’s sarcoma (KS) continues to occur in patients with human immunodeficiency virus (HIV) infection in the era of highly active antiretroviral therapy (HAART), and remains the most common HIV-associated malignancy. This retrospective study was conducted to describe the change in incidence and characteristics of HIV-associated KS in Taiwan.
 



 

Methods:

The medical records of patients with HIV infection who received a diagnosis of KS at the National Taiwan University Hospital between June 1994 and March 2008 were reviewed.
 



 

Results:

During the 14-year study period, 62 HIV-infected patients were diagnosed with KS, which included 40 definite diagnoses (64.5%) by pathology and 22 probable diagnoses (35.5%) ascertained by characteristic lesions, compatible clinical manifestations, and response to treatment. Most of the patients were men who have sex with men (MSM; n = 53; 85.5%). At the time of diagnosis of KS, the median CD4 count was 20 cells/μL (range, 1-371 cells/μL). A considerable decline in the incidence of KS in HIV-infected patients since the introduction of HAART was demonstrated; in the pre-HAART era, 18 of 175 patients (10.3%; 95% confidence interval [CI], 6.53-15.75) developed KS, compared with 44 of 1615 patients in the HAART era (2.7%; 95% CI, 2.03-3.65) [p < 0.0001]. The prognosis of HIV-infected patients with KS has improved since the introduction of HAART, as the mortality rate has declined from 77.8% in the pre-HAART era to 34.1% in the HAART era (p = 0.002).



 

Conclusion:

The incidence of KS in HIV-infected patients and the mortality rate of these patients significantly declined in the HAART era, although KS continued to occur in patients with advanced HIV infection.



 

Key words:

Acquired immunodeficiency syndrome; HIV; Sarcoma, Kaposi; Taiwan

 



 

J Microbiol Immunol Infect. 2009;42:227-233.