title: Kaposi Sarcoma Risk in HIV-Infected Children and Adolescents on Combination Antiretroviral Therapy From Sub-Saharan Africa, Europe, and Asia.
abstract: The burden of Kaposi sarcoma (KS) in human immunodeficiency virus (HIV)-infected children and adolescents on combination antiretroviral therapy (cART) has not been compared globally.
  
  
  
  We analyzed cohort data from the International Epidemiologic Databases to Evaluate AIDS and the Collaboration of Observational HIV Epidemiological Research in Europe. We included HIV-infected children aged <16 years at cART initiation from 1996 onward. We used Cox models to calculate hazard ratios (HRs), adjusted for region and origin, sex, cART start year, age, and HIV/AIDS stage at cART initiation.
  
  
  
  We included 24 991 children from eastern Africa, southern Africa, Europe and Asia; 26 developed KS after starting cART. Incidence rates per 100 000 person-years (PYs) were 86 in eastern Africa (95% confidence interval [CI], 55-133), 11 in southern Africa (95% CI, 4-35), and 81 (95% CI, 26-252) in children of sub-Saharan African (SSA) origin in Europe. The KS incidence rates were 0/100 000 PYs in children of non-SSA origin in Europe (95% CI, 0-50) and in Asia (95% CI, 0-27). KS risk was lower in girls than in boys (adjusted HR [aHR], 0.3; 95% CI, .1-.9) and increased with age (10-15 vs 0-4 years; aHR, 3.4; 95% CI, 1.2-10.1) and advanced HIV/AIDS stage (CDC stage C vs A/B; aHR, 2.4; 95% CI, .8-7.3) at cART initiation.
  
  
  
  HIV-infected children from SSA but not those from other regions, have a high risk of developing KS after cART initiation. Early cART initiation in these children might reduce KS risk.
authors: Eliane
authors: E
authors: Rohner
authors: Kurt
authors: K
authors: Schmidlin
authors: Marcel
authors: M
authors: Zwahlen
authors: Rana
authors: R
authors: Chakraborty
authors: Gary
authors: G
authors: Clifford
authors: Niels
authors: N
authors: Obel
authors: Sophie
authors: S
authors: Grabar
authors: Annelies
authors: A
authors: Verbon
authors: Antoni
authors: A
authors: Noguera-Julian
authors: Intira Jeannie
authors: IJ
authors: Collins
authors: Pablo
authors: P
authors: Rojo
authors: Norbert
authors: N
authors: Brockmeyer
authors: Maria
authors: M
authors: Campbell
authors: Geneviève
authors: G
authors: Chêne
authors: Hans
authors: H
authors: Prozesky
authors: Brian
authors: B
authors: Eley
authors: D Cristina
authors: DC
authors: Stefan
authors: Alan
authors: A
authors: Davidson
authors: Cleophas
authors: C
authors: Chimbetete
authors: Shobna
authors: S
authors: Sawry
authors: Mary-Ann
authors: MA
authors: Davies
authors: Azar
authors: A
authors: Kariminia
authors: Ung
authors: U
authors: Vibol
authors: Annette
authors: A
authors: Sohn
authors: Matthias
authors: M
authors: Egger
authors: Julia
authors: J
authors: Bohlius
mesh_terms: D000293:Adolescent; D017954:Africa South of the Sahara / Q000453:epidemiology; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001208:Asia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005060:Europe / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018570:Risk Assessment; D012514:Sarcoma, Kaposi / Q000150:complications / Q000453:epidemiology*; D061665:Time-to-Treatment
chemical_list: D019380:Anti-HIV Agents
keywords: HIV; Kaposi sarcoma; antiretroviral therapy; children; cohort study