The effect of HAART in 254 consecutive patients with AIDS-related Kaposi's sarcoma.
OBJECTIVE
A prospective cohort study was performed to evaluate the clinical outcomes of patients with histologically confirmed AIDS-related Kaposi's sarcoma diagnosed since the introduction of HAART.


METHODS
Two hundred and fifty-four consecutive patients (96% men) diagnosed with Kaposi's sarcoma between 1996 and 2008 are included. Clinicopathological and treatment details were prospectively collected. The median follow-up is over 4 years and maximum 12 years.


RESULTS
The mean age at Kaposi's sarcoma diagnosis was 39 years and average duration of known HIV seropositivity was 4 years. At Kaposi's sarcoma diagnosis, only 19% patients were on HAART and only 7% patients had an undetectable plasma HIV viral load. Seventy-nine (31%) patients had AIDS clinical Trial Group stage T1 disease at Kaposi's sarcoma diagnosis and 122 (48%) had AIDS clinical Trial Group stage I1 disease (CD4 cell count < 150 cells/microl). Nodular grade Kaposi's sarcoma represented 28% of the tumours and was significantly associated with black African ethnicity and AIDS clinical Trial Group T1 stage disease. The overall 5-year survival is 89% (95% confidence interval 84-93). One hundred and sixty-three patients were treated with HAART alone for T0 stage Kaposi's sarcoma; only one died of Kaposi's sarcoma and only 37 (22%) required chemotherapy, giving a systemic treatment-free survival at 5 years of 74% (95% confidence interval 67-82) and the overall survival at 5 years is 91% (95% confidence interval 87-95).


CONCLUSIONS
The high success rate of HAART in a large cohort of AIDS-Kaposi's sarcoma patients over a prolonged period of follow-up will reassure patients and clinicians that this is a well tolerated and effective approach to stage T0 Kaposi's sarcoma.
Bower
Mark
M
Department of Oncology, Chelsea and Westminster Hospital, London, UK. m.bower@imperial.ac.uk
Weir
Justin
J
Francis
Nicholas
N
Newsom-Davis
Tom
T
Powles
Sam
S
Crook
Tim
T
Boffito
Marta
M
Gazzard
Brian
B
Nelson
Mark
M
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy*; D000293:Adolescent; D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012514:Sarcoma, Kaposi / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D016896:Treatment Outcome; D019562:Viral Load; D055815:Young Adult