NDLI: AIDS-associated Kaposi sarcoma: outcomes after initiation of antiretroviral therapy at a university-affiliated hospital in urban Zimbabwe.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Nelson, Bradley C. Borok, Margaret Z. Mhlanga, Tafadzwa O. Makadzange, Azure T. Campbell, Thomas B.
Spatial Coverage	Zimbabwe
Description	Author Affiliation: Nelson BC ( Department of Medicine, Division of Cardiovascular Disease, University of California San Diego Health System, 9444 Medical Center Dr, La Jolla, CA 92107, USA)
Abstract	OBJECTIVE: To retrospectively investigate the outcomes of patients with AIDS-associated Kaposi sarcoma (AIDS-KS) after initiation of antiretroviral therapy (ART), under routine practice conditions, at a university-affiliated hospital in urban Zimbabwe. BACKGROUND: While studies from developed nations have demonstrated excellent outcomes for AIDS-KS patients treated with ART, few studies have examined the outcomes of African AIDS-KS patients after starting therapy. METHODS: A retrospective cohort of 124 AIDS patients initiating ART under routine practice conditions was studied. Thirty-one patients with AIDS-KS were matched 1:3 to 93 AIDS patients without KS (non-KS). The primary outcome was loss-to-care after initiation of therapy. Multivariate analysis was performed to identify significant predictors of loss-to-care. The percent change in weight at 6 months after starting ART was a secondary outcome. A sub-group analysis evaluated differences in pre-treatment variables between AIDS-KS patients retained-in-care compared to those lost-to-care. RESULTS: AIDS-KS patients had significantly greater 2-year proportional loss-to-care than matched non-KS AIDS patients (26.4% vs. 9.5%; p = 0.01) after initiation of ART. In multivariate analysis, the presence of KS (p = 0.02) was the only significant predictor of loss-to-care. AIDS-KS patients had significantly less weight gain after starting ART than non-KS AIDS patients (+3.4% vs. +6.4%; p = 0.03). AIDS-KS patients retained-in-care had significantly higher pre-treatment CD4+ lymphocyte counts than AIDS-KS patients lost-to-care (223 vs. 110 cells/mm(3); p = 0.04). CONCLUSIONS: In this retrospective study, AIDS-KS patients experienced significantly worse outcomes than matched non-KS AIDS patients after initiation of ART. AIDS-KS patients with higher pre-treatment CD4+ lymphocyte counts were more likely to be retained in care.
File Format	HTM / HTML
ISSN	12019712
e-ISSN	18783511
Journal	International Journal of Infectious Diseases
Issue Number	10
Volume Number	17
Language	English
Publisher	Elsevier
Publisher Date	2013-10-01
Publisher Place	Canada
Access Restriction	Open
Subject Keyword	Discipline Communicable Diseases Acquired Immunodeficiency Syndrome Drug Therapy Anti-hiv Agents Administration & Dosage Coinfection Sarcoma, Kaposi Complications Mortality Virology Drug Therapy, Combination Hiv-1 Herpesvirus 8, Human Hospitals, University Kaplan-meier Estimate Lamivudine Multivariate Analysis Nevirapine Proportional Hazards Models Retrospective Studies Etiology Stavudine Urban Population Zimbabwe Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Infectious Diseases Microbiology (medical)

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