HIV-1-associated Kaposi's sarcoma in a predominantly black population at an inner city hospital.
BACKGROUND
Kaposi's sarcoma (KS) associated with human immunodeficiency virus type 1 (HIV-1) is the most common malignancy in patients with AIDS. It has been most commonly reported in white homosexual men, though a few cases have been reported in blacks.


METHODS
We conducted a retrospective analysis of all HIV-1 seropositive patients with biopsy-proven KS seen at Howard University Hospital between February 1985 and June 1995.


RESULTS
Of the 73 patients identified, 66 (90%), 4 were white, 2 were Hispanic, and 1 was of unidentified race. The median age was 32 years. Forty-eight (66%) were homosexual or bisexual men, and 10 (14%) were homosexual or bisexual with a history of intravenous drug use (IDU). A history of IDU or blood transfusion was the only risk factor in 7 (9%) and 2 (3%), respectively. The other 6 (8)% were heterosexual. The median survival was 2.2 years. A CD4 count <200 and the presence of an opportunistic infection were associated with shortened survival.


CONCLUSIONS
The predominant risk factor for HIV-1-associated KS was homosexual or bisexual activity. Only a few women with KS were identified, and they also reported sexual transmission from male bisexuals and/or drug users. Poor survival was associated with CD4 <200, stage III and IV KS at presentation, and opportunistic infections.
Dawkins
F W
FW
Department of Medicine, Howard University College of Medicine, Washington, DC, USA.
Delapenha
R A
RA
Frezza
E E
EE
Green
W R
WR
Hardy
C
C
Frederick
W R
WR
Manns
A
A
D000328:Adult; D001727:Bisexuality / Q000706:statistics & numerical data; D044383:Black People; D004219:District of Columbia / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000276:immunology / Q000635:transmission; D015497:HIV-1 / Q000276:immunology; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012514:Sarcoma, Kaposi / Q000453:epidemiology* / Q000276:immunology; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000276:immunology; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology / Q000276:immunology; D015996:Survival Rate; D014505:Urban Population / Q000706:statistics & numerical data*; D001741:Black or African American