title: Incidence and trends in Kaposi's sarcoma in the era of effective antiretroviral therapy.
abstract: OBJECTIVE
  To evaluate the impact of antiretroviral and antiherpesvirus therapies on the incidence of KS and assess trends in incidence of Kaposi's sarcoma (KS) in a large multicenter HIV/AIDS surveillance system between 1990 and 1998.
  
  
  METHODS
  Incidence was calculated per 100 person-years (py); the effects of therapies on risk for KS were calculated by using multivariate Poisson regression controlling for gender, race/ethnicity, age, HIV exposure mode, CD4+ cell count, and calendar year. Antiretroviral therapy was defined as monotherapy, dual therapy, or triple therapy (95% of triple therapy regimens contained a protease inhibitor). Acyclovir, ganciclovir, and foscarnet were the antiherpesvirus therapies evaluated.
  
  
  RESULTS
  There were 37,303 HIV-infected people in the study contributing 70,238 py. Those prescribed triple antiretroviral therapy had a 50% reduction in the incidence of KS (95% confidence interval, 20%-70%) compared with those who were not prescribed antiretroviral therapy and there was a reduction in risk for KS among persons prescribed foscarnet (p =.05). Overall, KS incidence declined an estimated 8.8% per year (observed incidence 4. 1 per 100 py in 1990 to 0.7 per 100 py in 1998; p <.001).
  
  
  CONCLUSIONS
  Incidence of KS is declining in this large U.S. population and may continue to decline as new, more effective antiretroviral agents are developed and used widely.
authors.affiliation: Division of HIV/AIDS Prevention Surveillance and Epidemiology, National Center for HIV, STD, and TB Prevention, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30341-3724, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Jones
authors.forename: D L
authors.initials: DL
authors.lastname: Hanson
authors.forename: M S
authors.initials: MS
authors.lastname: Dworkin
authors.forename: H W
authors.initials: HW
authors.lastname: Jaffe
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000209:etiology; D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D017245:Foscarnet / Q000627:therapeutic use; D015774:Ganciclovir / Q000627:therapeutic use; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D018451:Homosexuality, Male; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D012189:Retrospective Studies; D012307:Risk Factors; D012514:Sarcoma, Kaposi / Q000453:epidemiology* / Q000209:etiology; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000209:etiology
chemical_list: D019380:Anti-HIV Agents; D017245:Foscarnet; D015774:Ganciclovir; D000212:Acyclovir