title: Kaposi's sarcoma in patients with human immunodeficiency virus infection in Taiwan.
abstract: OBJECTIVE
  Kaposi's sarcoma (KS) continues to occur in patients with human immunodeficiency virus (HIV) infection in the era of highly active antiretroviral therapy (HAART), and remains the most common HIV-associated malignancy. This retrospective study was conducted to describe the change in incidence and characteristics of HIV-associated KS in Taiwan.
  
  
  METHODS
  The medical records of patients with HIV infection who received a diagnosis of KS at the National Taiwan University Hospital between June 1994 and March 2008 were reviewed.
  
  
  RESULTS
  During the 14-year study period, 62 HIV-infected patients were diagnosed with KS, which included 40 definite diagnoses (64.5%) by pathology and 22 probable diagnoses (35.5%) ascertained by characteristic lesions, compatible clinical manifestations, and response to treatment. Most of the patients were men who have sex with men (MSM; n = 53; 85.5%). At the time of diagnosis of KS, the median CD4 count was 20 cells/microL (range, 1-371 cells/microL). A considerable decline in the incidence of KS in HIV-infected patients since the introduction of HAART was demonstrated; in the pre-HAART era, 18 of 175 patients (10.3%; 95% confidence interval [CI], 6.53- 15.75) developed KS, compared with 44 of 1615 patients in the HAART era (2.7%; 95% CI, 2.03-3.65) [p < 0.0001]. The prognosis of HIV-infected patients with KS has improved since the introduction of HAART, as the mortality rate has declined from 77.8% in the pre-HAART era to 34.1% in the HAART era (p = 0.002).
  
  
  CONCLUSIONS
  The incidence of KS in HIV-infected patients and the mortality rate of these patients significantly declined in the HAART era, although KS continued to occur in patients with advanced HIV infection.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Chi-Ying
authors.initials: CY
authors.lastname: Lin
authors.forename: Mao-Yuan
authors.initials: MY
authors.lastname: Chen
authors.forename: Szu-Min
authors.initials: SM
authors.lastname: Hsieh
authors.forename: Wang-Huei
authors.initials: WH
authors.lastname: Sheng
authors.forename: Hsin-Yun
authors.initials: HY
authors.lastname: Sun
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Lo
authors.forename: Chien-Ching
authors.initials: CC
authors.lastname: Hung
authors.forename: Shan-Chwen
authors.initials: SC
authors.lastname: Chang
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012514:Sarcoma, Kaposi / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology*; D018709:Statistics, Nonparametric; D013624:Taiwan / Q000453:epidemiology