Pulmonary Kaposi sarcoma in the era of highly active antiretroviral therapy.
OBJECTIVE
Since the introduction of highly active antiretroviral therapy (HAART) there has been a dramatic reduction in the incidence of Kaposi sarcoma (KS) and an improvement in survival. We wished to examine whether the outcome in pulmonary KS (pKS) has also altered.


METHODS
In a single-institution cohort of 1140 HIV-positive patients with KS, 305 patients were diagnosed in the HAART era (1996-2004). We examined the clinicopathological features and outcomes of these patients, of whom 25 had pKS and 280 did not.


RESULTS
Patients with pKS had lower CD4 cell counts at the time of KS diagnosis (Mann-Whitney U-test P=0.005). The incidence of pKS was higher in African patients than in non-African patients in this sample (Fisher's test, P=0.001). There were no significant differences in age, gender, plasma HIV-1 viral load or prior HAART treatment at the time of KS diagnosis. Five-year overall survival in the pKS group was 49% [95% confidence interval (CI) 26-73%] as compared with 82% (95% CI 76-87%) for the non-pKS group (log rank, P<0.0001).


CONCLUSIONS
PKS remains an ominous diagnosis in the era of HAART, with a median survival of just 1.6 years.
Palmieri
C
C
Department of Medical Oncology, The Chelsea and Westminster Hospital, London, UK.
Dhillon
T
T
Thirlwell
C
C
Newsom-Davis
T
T
Young
A-M
AM
Nelson
M
M
Gazzard
B G
BG
Bower
M
M
D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D044383:Black People; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D015497:HIV-1; D006801:Humans; D008131:London / Q000453:epidemiology; D008175:Lung Neoplasms / Q000150:complications / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012514:Sarcoma, Kaposi / Q000150:complications / Q000453:epidemiology*; D016019:Survival Analysis