Kaposi's sarcoma in transplant and HIV-infected patients: an epidemiologic study in Italy and France.
BACKGROUND
A follow-up study was conducted in Italy and in France to compare the epidemiology of Kaposi's sarcoma (KS) between human immunodeficiency virus (HIV)-infected people and transplant recipients.


METHODS
In all, 8,074 HIV-positive individuals (6,072 from France and 2,002 HIV-seroconverters from Italy) and 2,705 Italian transplant recipients (1,844 kidney transplants, 702 heart transplants, and 159 liver transplants) were followed-up between 1970 and 2004. Standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were computed to estimate the risk of KS, as compared to sex- and age-matched Italian and French populations. Incidence rate ratios (IRRs) were used to identify risk factors for KS.


RESULTS
A 451-fold higher SIR for KS was recorded in HIV-infected subjects and a 128-fold higher SIR was seen in transplant recipients. Significantly increased KS risks were observed in HIV-infected homosexual men (IRR=9.7 in France and IRR=6.7 in Italy vs. intravenous drug users), and in transplant recipients born in southern Italy (IRR=5.2 vs. those born in northern Italy). HIV-infected patients with high CD4+ cell counts and those treated with antiretroviral therapies had reduced KS risks. In relation to duration of immunosuppression, KS occurred earlier in transplant patients than in HIV-seroconverters.


CONCLUSIONS
This comparison highlighted that the risk of KS was higher among HIV-infected individuals than in transplant recipients, and that different co-factors are likely to influence the risk of KS. Moreover, the early KS occurrence in transplant recipients could be associated with different patterns of progressive impairment of the immune function.
Serraino
Diego
D
Dip. Epidemiologia, INMI L. Spallanzani, Rome, Italy. serrainod@cro.it
Angeletti
Claudio
C
Carrieri
Maria P
MP
Longo
Benedetta
B
Piche
Marjorie
M
Piselli
Pierluca
P
Arbustini
Eloisa
E
Burra
Patrizia
P
Citterio
Franco
F
Colombo
Valeria
V
Fuzibet
Jean G
JG
Dal Bello
Barbara
B
Targhetta
Stefano
S
Grasso
Maurizia
M
Pozzetto
Ubaldo
U
Bellelli
Stefania
S
Dorrucci
Maria
M
Dal Maso
Luigino
L
Busnach
Ghil
G
Pradier
Christian
C
Rezza
Giovanni
G
D000328:Adult; D017668:Age of Onset; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012514:Sarcoma, Kaposi / Q000453:epidemiology*; D013997:Time Factors