title: Age patterns of Kaposi's sarcoma incidence in a cohort of HIV-infected men.
abstract: The life expectancy for HIV-positive individuals has improved over time due to increasing access to highly active antiretroviral therapy (HAART). Yet, as the HIV-positive population ages, their risk of developing cancers also increases. Studies of Kaposi's sarcoma (KS) among elderly HIV-infected persons are quite limited. We examined the age patterns of KS incidence and an association between age and KS risk in a US cohort of 3458 HIV-infected men, the Multicenter AIDS Cohort Study (MACS). Poisson distribution was used to calculate incidence rates and respective 95% confidence intervals (95% CIs). Cox proportional hazards regression was performed to examine the association between age and KS risk. There were 534 incident KS cases with a total follow-up time of 25,134 person-years. The overall KS incidence rate was 2.13 per 100 person-years (95% CI: 1.95-2.32) (Non-HAART users-ever: 5.57 per 100 person-years [95% CI: 5.09-6.10]; HAART users-ever: 0.39 per 100 person-years [95% CI: 0.31-0.51]). Overall, KS frequency and incidence declined with age, even in the oldest age group (p(trend) < 0.0001). However, among non-HAART users-ever, the oldest age group had the highest incidence rate ratio compared to younger individuals [15.01, 95% CI: 6.12-44.22]). While the incidence of KS decreased with age, older HIV-infected persons who do not receive HAART are still at increased risk of KS. As KS remains an important malignancy among HIV-infected persons, earlier HIV diagnoses and HAART initiation, particularly in older HIV-infected persons is warranted.
authors.affiliation: Disivion of Epidemiology, Department of Medicine, School of Medicine, Vanderbilt University, Nashville, Tennessee; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas.
authors.forename: Hung N
authors.initials: HN
authors.lastname: Luu
authors.forename: E Susan
authors.initials: ES
authors.lastname: Amirian
authors.forename: Elizabeth Y
authors.initials: EY
authors.lastname: Chiao
authors.forename: Michael E
authors.initials: ME
authors.lastname: Scheurer
mesh_terms: D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D015658:HIV Infections / Q000453:epidemiology* / Q000473:pathology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D012514:Sarcoma, Kaposi / Q000453:epidemiology* / Q000821:virology*; D014481:United States / Q000453:epidemiology
keywords: HIV-infected men; Kaposi's sarcoma; incidence patterns by age