Kaposi sarcoma risk in HIV-infected children and adolescents on combination antiretroviral therapy from sub-Saharan Africa, Europe, and Asia

Rohner, E.; Schmidlin, K.; Zwahlen, M.; Chakraborty, R.; Clifford, G.; Obel, N.; Grabar, S.; Verbon, A.; Noguera-Julian, A.; Judd, A.; Collins, I. J.; Rojo, P.; Brockmeyer, N.; Campbell, M.; Chene, G.; Prozesky, H.; Eley, B.; Stefan, D.; Davidson, A.; Chimbetete, C.; Sawry, S.; Davies, M. -A.; Kariminia, A.; Vibol, U.; Sohn, A.; Egger, M.; Bohlius, J.; Tanser, F.; Vinikoor, M.; Macete, E.; Wood, R.; Stinson, K.; Garone, D.; Fatti, G.; Phiri, S.; Giddy, J.; Malisita, K.; Fritz, C.; Hobbins, M.; Kamenova, K.; Fox, M.; Technau, K.; Zangerle, R.; Touloumi, G.; Warszawski, J.; Meyer, L.; Dabis, F.; Krause, M. M.; Ghosn, J.; Leport, C.; Wittkop, L.; Reiss, P.; Wit, F.; Prins, M.; Bucher, H.; Sabin, C.; Gibb, D.; Fatkenheuer, G.; Del Amo, J.; Thorne, C.; Mocroft, A.; Kirk, O.; Stephan, C.; Perez-Hoyos, S.; Hamouda, O.; Bartmeyer, B.; Chkhartishvili, N.; Antinori, A.; Monforte, A. D.; Prieto, L.; Soriano-Arandes, A.; Battegay, M.; Kouyos, R.; Mussini, C.; Tookey, P.; Casabona, J.; Miro, J. M.; Castagna, A.; Konopnick, D.; Goetghebuer, T.; Sonnerborg, A.; Torti, C.; Teira, R.; Garrido, M.; Haerry, D.; De Wit, S.; Costagliola, D.; Raben, D.; Barger, D.; Schwimmer, C.; Termote, M.; Frederiksen, C.; Friis-Moller, N.; Berenguer, J.; Bouteloup, V.; Cozzi-Lepri, A.; Dorrucci, M.; Dunn, D.; Furrer, H.; Guiguet, M.; Lambotte, O.; Leroy, V.; Lodi, S.; Matheron, S.; Monge, S.; Nakagawa, F.; Paredes, R.; Peters, L.; Phillips, A.; Puoti, M.; Schomaker, M.; Smit, C.; Sterne, J.; Thiebaut, R.; Van Der Valk, M.; P. S., Ly; Khol, V.; Sarun, S. M.; Ung, V. B.; Tucker, J.; Kumarasamy, N.; Saghayam, S.; Chandrasekaran, E.; Wati, D. K.; Atmikasari, L. P. P.; Malino, I. Y.; Kurniati, N.; Muktiarti, D.; Fong, S. M.; Lim, M.; Daut, F.; Nik Yusoff, N. K.; Mohamad, P.; Razali, K. A.; Mohamed, T. J.; Mohammed, N. A. D. R.; Nallusamy, R.; Chan, K. C.; Sudjaritruk, T.; Sirisanthana, V.; Aurpibul, L.; Oberdorfer, P.; Hansudewechakul, R.; Denjanta, S.; Srisuk, W.; Kongphonoi, A.; Lumbiganon, P.; Kosalaraksa, P.; Tharnprisan, P.; Udomphanit, T.; Jourdain, G.; Bunupuradah, T.; Puthanakit, T.; Prasitsuebsai, W.; Chanthaweethip, W.; Chokephaibulkit, K.; Lapphra, K.; Phongsamart, W.; Sricharoenchai, S.; Truong, K. H.; Q. T., Du; Nguyen, C. H.; V. C., Do; T. M., Ha; V. T., An; Nguyen, L. V.; Khu, D. T. K.; Pham, A. N.; Nguyen, L. T.; O. N., Le; Sohn, A. H.; Sethaputra, C.; Cooper, D. A.; Law, M. G.

doi:10.1093/cid/ciw519

Background. 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. Methods. 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. Results. 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. Conclusions. 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.

Kaposi sarcoma risk in HIV-infected children and adolescents on combination antiretroviral therapy from sub-Saharan Africa, Europe, and Asia / Rohner, E.; Schmidlin, K.; Zwahlen, M.; Chakraborty, R.; Clifford, G.; Obel, N.; Grabar, S.; Verbon, A.; Noguera-Julian, A.; Judd, A.; Collins, I. J.; Rojo, P.; Brockmeyer, N.; Campbell, M.; Chene, G.; Prozesky, H.; Eley, B.; Stefan, D.; Davidson, A.; Chimbetete, C.; Sawry, S.; Davies, M. -A.; Kariminia, A.; Vibol, U.; Sohn, A.; Egger, M.; Bohlius, J.; Tanser, F.; Vinikoor, M.; Macete, E.; Wood, R.; Stinson, K.; Garone, D.; Fatti, G.; Phiri, S.; Giddy, J.; Malisita, K.; Fritz, C.; Hobbins, M.; Kamenova, K.; Fox, M.; Technau, K.; Zangerle, R.; Touloumi, G.; Warszawski, J.; Meyer, L.; Dabis, F.; Krause, M. M.; Ghosn, J.; Leport, C.; Wittkop, L.; Reiss, P.; Wit, F.; Prins, M.; Bucher, H.; Sabin, C.; Gibb, D.; Fatkenheuer, G.; Del Amo, J.; Thorne, C.; Mocroft, A.; Kirk, O.; Stephan, C.; Perez-Hoyos, S.; Hamouda, O.; Bartmeyer, B.; Chkhartishvili, N.; Antinori, A.; Monforte, A. D.; Prieto, L.; Soriano-Arandes, A.; Battegay, M.; Kouyos, R.; Mussini, C.; Tookey, P.; Casabona, J.; Miro, J. M.; Castagna, A.; Konopnick, D.; Goetghebuer, T.; Sonnerborg, A.; Torti, C.; Teira, R.; Garrido, M.; Haerry, D.; De Wit, S.; Costagliola, D.; Raben, D.; Barger, D.; Schwimmer, C.; Termote, M.; Frederiksen, C.; Friis-Moller, N.; Berenguer, J.; Bouteloup, V.; Cozzi-Lepri, A.; Dorrucci, M.; Dunn, D.; Furrer, H.; Guiguet, M.; Lambotte, O.; Leroy, V.; Lodi, S.; Matheron, S.; Monge, S.; Nakagawa, F.; Paredes, R.; Peters, L.; Phillips, A.; Puoti, M.; Schomaker, M.; Smit, C.; Sterne, J.; Thiebaut, R.; Van Der Valk, M.; Ly, P. S.; Khol, V.; Sarun, S. M.; Ung, V. B.; Tucker, J.; Kumarasamy, N.; Saghayam, S.; Chandrasekaran, E.; Wati, D. K.; Atmikasari, L. P. P.; Malino, I. Y.; Kurniati, N.; Muktiarti, D.; Fong, S. M.; Lim, M.; Daut, F.; Nik Yusoff, N. K.; Mohamad, P.; Razali, K. A.; Mohamed, T. J.; Mohammed, N. A. D. R.; Nallusamy, R.; Chan, K. C.; Sudjaritruk, T.; Sirisanthana, V.; Aurpibul, L.; Oberdorfer, P.; Hansudewechakul, R.; Denjanta, S.; Srisuk, W.; Kongphonoi, A.; Lumbiganon, P.; Kosalaraksa, P.; Tharnprisan, P.; Udomphanit, T.; Jourdain, G.; Bunupuradah, T.; Puthanakit, T.; Prasitsuebsai, W.; Chanthaweethip, W.; Chokephaibulkit, K.; Lapphra, K.; Phongsamart, W.; Sricharoenchai, S.; Truong, K. H.; Du, Q. T.; Nguyen, C. H.; Do, V. C.; Ha, T. M.; An, V. T.; Nguyen, L. V.; Khu, D. T. K.; Pham, A. N.; Nguyen, L. T.; Le, O. N.; Sohn, A. H.; Sethaputra, C.; Cooper, D. A.; Law, M. G.. - In: CLINICAL INFECTIOUS DISEASES. - ISSN 1058-4838. - 63:9(2016), pp. 1245-1253. [10.1093/cid/ciw519]

Kaposi sarcoma risk in HIV-infected children and adolescents on combination antiretroviral therapy from sub-Saharan Africa, Europe, and Asia

Rohner E.;Schmidlin K.;Zwahlen M.;Chakraborty R.;Clifford G.;Obel N.;Grabar S.;Verbon A.;Noguera-Julian A.;Judd A.;Collins I. J.;Rojo P.;Brockmeyer N.;Campbell M.;Chene G.;Prozesky H.;Eley B.;Stefan D.;Davidson A.;Chimbetete C.;Sawry S.;Davies M. -A.;Kariminia A.;Vibol U.;Sohn A.;Egger M.;Bohlius J.;Tanser F.;Vinikoor M.;Macete E.;Wood R.;Stinson K.;Garone D.;Fatti G.;Phiri S.;Giddy J.;Malisita K.;Fritz C.;Hobbins M.;Kamenova K.;Fox M.;Technau K.;Zangerle R.;Touloumi G.;Warszawski J.;Meyer L.;Dabis F.;Krause M. M.;Ghosn J.;Leport C.;Wittkop L.;Reiss P.;Wit F.;Prins M.;Bucher H.;Sabin C.;Gibb D.;Fatkenheuer G.;Del Amo J.;Thorne C.;Mocroft A.;Kirk O.;Stephan C.;Perez-Hoyos S.;Hamouda O.;Bartmeyer B.;Chkhartishvili N.;Antinori A.;Monforte A. D.;Prieto L.;Soriano-Arandes A.;Battegay M.;Kouyos R.;Mussini C.;Tookey P.;Casabona J.;Miro J. M.;Castagna A.;Konopnick D.;Goetghebuer T.;Sonnerborg A.;Torti C.;Teira R.;Garrido M.;Haerry D.;De Wit S.;Costagliola D.;Raben D.;Barger D.;Schwimmer C.;Termote M.;Frederiksen C.;Friis-Moller N.;Berenguer J.;Bouteloup V.;Cozzi-Lepri A.;Dorrucci M.;Dunn D.;Furrer H.;Guiguet M.;Lambotte O.;Leroy V.;Lodi S.;Matheron S.;Monge S.;Nakagawa F.;Paredes R.;Peters L.;Phillips A.;Puoti M.;Schomaker M.;Smit C.;Sterne J.;Thiebaut R.;Van Der Valk M.;Ly P. S.;Khol V.;Sarun S. M.;Ung V. B.;Tucker J.;Kumarasamy N.;Saghayam S.;Chandrasekaran E.;Wati D. K.;Atmikasari L. P. P.;Malino I. Y.;Kurniati N.;Muktiarti D.;Fong S. M.;Lim M.;Daut F.;Nik Yusoff N. K.;Mohamad P.;Razali K. A.;Mohamed T. J.;Mohammed N. A. D. R.;Nallusamy R.;Chan K. C.;Sudjaritruk T.;Sirisanthana V.;Aurpibul L.;Oberdorfer P.;Hansudewechakul R.;Denjanta S.;Srisuk W.;Kongphonoi A.;Lumbiganon P.;Kosalaraksa P.;Tharnprisan P.;Udomphanit T.;Jourdain G.;Bunupuradah T.;Puthanakit T.;Prasitsuebsai W.;Chanthaweethip W.;Chokephaibulkit K.;Lapphra K.;Phongsamart W.;Sricharoenchai S.;Truong K. H.;Du Q. T.;Nguyen C. H.;Do V. C.;Ha T. M.;An V. T.;Nguyen L. V.;Khu D. T. K.;Pham A. N.;Nguyen L. T.;Le O. N.;Sohn A. H.;Sethaputra C.;Cooper D. A.;Law M. G.

2016

Abstract

Background. 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. Methods. 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. Results. 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. Conclusions. 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.

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	Anno di pubblicazione
	
				2016
			
	Rivista
	
				CLINICAL INFECTIOUS DISEASES
			
	N° del Volume
	
				63
			
	Fascicolo
	
				9
			
	Pagina iniziale
	
				1245
			
	Pagina finale
	
				1253
			
	Codice DOI
	
				https://dx.doi.org/10.1093/cid/ciw519
			
	Codice WoS
	
				WOS:000387986200021
			
	Codice Scopus
	
				2-s2.0-84994517593
			
	Codice PubMed
	
				27578823
			
	Citazione
	
				Kaposi sarcoma risk in HIV-infected children and adolescents on combination antiretroviral therapy from sub-Saharan Africa, Europe, and Asia / Rohner, E.; Schmidlin, K.; Zwahlen, M.; Chakraborty, R.; Clifford, G.; Obel, N.; Grabar, S.; Verbon, A.; Noguera-Julian, A.; Judd, A.; Collins, I. J.; Rojo, P.; Brockmeyer, N.; Campbell, M.; Chene, G.; Prozesky, H.; Eley, B.; Stefan, D.; Davidson, A.; Chimbetete, C.; Sawry, S.; Davies, M. -A.; Kariminia, A.; Vibol, U.; Sohn, A.; Egger, M.; Bohlius, J.; Tanser, F.; Vinikoor, M.; Macete, E.; Wood, R.; Stinson, K.; Garone, D.; Fatti, G.; Phiri, S.; Giddy, J.; Malisita, K.; Fritz, C.; Hobbins, M.; Kamenova, K.; Fox, M.; Technau, K.; Zangerle, R.; Touloumi, G.; Warszawski, J.; Meyer, L.; Dabis, F.; Krause, M. M.; Ghosn, J.; Leport, C.; Wittkop, L.; Reiss, P.; Wit, F.; Prins, M.; Bucher, H.; Sabin, C.; Gibb, D.; Fatkenheuer, G.; Del Amo, J.; Thorne, C.; Mocroft, A.; Kirk, O.; Stephan, C.; Perez-Hoyos, S.; Hamouda, O.; Bartmeyer, B.; Chkhartishvili, N.; Antinori, A.; Monforte, A. D.; Prieto, L.; Soriano-Arandes, A.; Battegay, M.; Kouyos, R.; Mussini, C.; Tookey, P.; Casabona, J.; Miro, J. M.; Castagna, A.; Konopnick, D.; Goetghebuer, T.; Sonnerborg, A.; Torti, C.; Teira, R.; Garrido, M.; Haerry, D.; De Wit, S.; Costagliola, D.; Raben, D.; Barger, D.; Schwimmer, C.; Termote, M.; Frederiksen, C.; Friis-Moller, N.; Berenguer, J.; Bouteloup, V.; Cozzi-Lepri, A.; Dorrucci, M.; Dunn, D.; Furrer, H.; Guiguet, M.; Lambotte, O.; Leroy, V.; Lodi, S.; Matheron, S.; Monge, S.; Nakagawa, F.; Paredes, R.; Peters, L.; Phillips, A.; Puoti, M.; Schomaker, M.; Smit, C.; Sterne, J.; Thiebaut, R.; Van Der Valk, M.; Ly, P. S.; Khol, V.; Sarun, S. M.; Ung, V. B.; Tucker, J.; Kumarasamy, N.; Saghayam, S.; Chandrasekaran, E.; Wati, D. K.; Atmikasari, L. P. P.; Malino, I. Y.; Kurniati, N.; Muktiarti, D.; Fong, S. M.; Lim, M.; Daut, F.; Nik Yusoff, N. K.; Mohamad, P.; Razali, K. A.; Mohamed, T. J.; Mohammed, N. A. D. R.; Nallusamy, R.; Chan, K. C.; Sudjaritruk, T.; Sirisanthana, V.; Aurpibul, L.; Oberdorfer, P.; Hansudewechakul, R.; Denjanta, S.; Srisuk, W.; Kongphonoi, A.; Lumbiganon, P.; Kosalaraksa, P.; Tharnprisan, P.; Udomphanit, T.; Jourdain, G.; Bunupuradah, T.; Puthanakit, T.; Prasitsuebsai, W.; Chanthaweethip, W.; Chokephaibulkit, K.; Lapphra, K.; Phongsamart, W.; Sricharoenchai, S.; Truong, K. H.; Du, Q. T.; Nguyen, C. H.; Do, V. C.; Ha, T. M.; An, V. T.; Nguyen, L. V.; Khu, D. T. K.; Pham, A. N.; Nguyen, L. T.; Le, O. N.; Sohn, A. H.; Sethaputra, C.; Cooper, D. A.; Law, M. G.. - In: CLINICAL INFECTIOUS DISEASES. - ISSN 1058-4838. - 63:9(2016), pp. 1245-1253. [10.1093/cid/ciw519]
			
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						Rohner, E.; Schmidlin, K.; Zwahlen, M.; Chakraborty, R.; Clifford, G.; Obel, N.; Grabar, S.; Verbon, A.; Noguera-Julian, A.; Judd, A.; Collins, I. J.;...espandi
						
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