Kaposi Sarcoma Risk in HIV-Infected Children and Adolescents on Combination Antiretroviral Therapy From Sub-Saharan Africa, Europe, and Asia

Eliane Rohner; Kurt Schmidlin; Marcel Zwahlen; Rana Chakraborty; Gary Clifford; Niels Obel; Sophie Grabar; Annelies Verbon; Antoni Noguera-Julian; Ali Judd; Intira Jeannie Collins; Pablo Rojo; Norbert Brockmeyer; Maria Campbell; Geneviève Chêne; Hans Prozesky; Brian Eley; D Cristina Stefan; Alan Davidson; Cleophas Chimbetete; Shobna Sawry; Mary-Ann Davies; Azar Kariminia; Ung Vibol; Annette Sohn; Matthias Egger; Julia Bohlius; Ole Kirk; Pediatric AIDS-Defining Cancer Project Working Group for IeDEA Southern Africa, TApHOD, and COHERE in EuroCoord

doi:10.1093/cid/ciw519

Kaposi Sarcoma Risk in HIV-Infected Children and Adolescents on Combination Antiretroviral Therapy From Sub-Saharan Africa, Europe, and Asia

Eliane Rohner, Kurt Schmidlin, Marcel Zwahlen, Rana Chakraborty, Gary Clifford, Niels Obel, Sophie Grabar, Annelies Verbon, Antoni Noguera-Julian, Ali Judd, Intira Jeannie Collins, Pablo Rojo, Norbert Brockmeyer, Maria Campbell, Geneviève Chêne, Hans Prozesky, Brian Eley, D Cristina Stefan, Alan Davidson, Cleophas ChimbeteteShobna Sawry, Mary-Ann Davies, Azar Kariminia, Ung Vibol, Annette Sohn, Matthias Egger, Julia Bohlius, Ole Kirk, Pediatric AIDS-Defining Cancer Project Working Group for IeDEA Southern Africa, TApHOD, and COHERE in EuroCoord

Department of Clinical Medicine

10 Citations (Scopus)

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.

Original language	English
Journal	Clinical Infectious Diseases
Volume	63
Issue number	9
Pages (from-to)	1245-1253
Number of pages	9
ISSN	1058-4838
DOIs	https://doi.org/10.1093/cid/ciw519
Publication status	Published - 1 Nov 2016

Keywords

Journal Article

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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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., Rojo, P., Brockmeyer, N., Campbell, M., Chêne, G., Prozesky, H., Eley, B., Stefan, D. C., Davidson, A., ... Pediatric AIDS-Defining Cancer Project Working Group for IeDEA Southern Africa, TApHOD, and COHERE in EuroCoord (2016). Kaposi Sarcoma Risk in HIV-Infected Children and Adolescents on Combination Antiretroviral Therapy From Sub-Saharan Africa, Europe, and Asia. Clinical Infectious Diseases, 63(9), 1245-1253. https://doi.org/10.1093/cid/ciw519

Rohner, E, Schmidlin, K, Zwahlen, M, Chakraborty, R, Clifford, G, Obel, N, Grabar, S, Verbon, A, Noguera-Julian, A, Judd, A, Collins, IJ, Rojo, P, Brockmeyer, N, Campbell, M, Chêne, G, Prozesky, H, Eley, B, Stefan, DC, Davidson, A, Chimbetete, C, Sawry, S, Davies, M-A, Kariminia, A, Vibol, U, Sohn, A, Egger, M, Bohlius, J, Kirk, O & Pediatric AIDS-Defining Cancer Project Working Group for IeDEA Southern Africa, TApHOD, and COHERE in EuroCoord 2016, 'Kaposi Sarcoma Risk in HIV-Infected Children and Adolescents on Combination Antiretroviral Therapy From Sub-Saharan Africa, Europe, and Asia', Clinical Infectious Diseases, vol. 63, no. 9, pp. 1245-1253. https://doi.org/10.1093/cid/ciw519

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title = "Kaposi Sarcoma Risk in HIV-Infected Children and Adolescents on Combination Antiretroviral Therapy From Sub-Saharan Africa, Europe, and Asia",

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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author = "Eliane Rohner and Kurt Schmidlin and Marcel Zwahlen and Rana Chakraborty and Gary Clifford and Niels Obel and Sophie Grabar and Annelies Verbon and Antoni Noguera-Julian and Ali Judd and Collins, {Intira Jeannie} and Pablo Rojo and Norbert Brockmeyer and Maria Campbell and Genevi{\`e}ve Ch{\^e}ne and Hans Prozesky and Brian Eley and Stefan, {D Cristina} and Alan Davidson and Cleophas Chimbetete and Shobna Sawry and Mary-Ann Davies and Azar Kariminia and Ung Vibol and Annette Sohn and Matthias Egger and Julia Bohlius and Ole Kirk and {Pediatric AIDS-Defining Cancer Project Working Group for IeDEA Southern Africa, TApHOD, and COHERE in EuroCoord}",

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doi = "10.1093/cid/ciw519",

language = "English",

volume = "63",

pages = "1245--1253",

journal = "Clinical Infectious Diseases",

issn = "1058-4838",

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TY - JOUR

T1 - Kaposi Sarcoma Risk in HIV-Infected Children and Adolescents on Combination Antiretroviral Therapy From Sub-Saharan Africa, Europe, and Asia

AU - Rohner, Eliane

AU - Schmidlin, Kurt

AU - Zwahlen, Marcel

AU - Chakraborty, Rana

AU - Clifford, Gary

AU - Obel, Niels

AU - Grabar, Sophie

AU - Verbon, Annelies

AU - Noguera-Julian, Antoni

AU - Judd, Ali

AU - Collins, Intira Jeannie

AU - Rojo, Pablo

AU - Brockmeyer, Norbert

AU - Campbell, Maria

AU - Chêne, Geneviève

AU - Prozesky, Hans

AU - Eley, Brian

AU - Stefan, D Cristina

AU - Davidson, Alan

AU - Chimbetete, Cleophas

AU - Sawry, Shobna

AU - Davies, Mary-Ann

AU - Kariminia, Azar

AU - Vibol, Ung

AU - Sohn, Annette

AU - Egger, Matthias

AU - Bohlius, Julia

AU - Kirk, Ole

AU - Pediatric AIDS-Defining Cancer Project Working Group for IeDEA Southern Africa, TApHOD, and COHERE in EuroCoord

PY - 2016/11/1

Y1 - 2016/11/1

N2 - 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.

AB - 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.

KW - Journal Article

U2 - 10.1093/cid/ciw519

DO - 10.1093/cid/ciw519

M3 - Journal article

C2 - 27578823

SN - 1058-4838

VL - 63

SP - 1245

EP - 1253

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

IS - 9

ER -

Kaposi Sarcoma Risk in HIV-Infected Children and Adolescents on Combination Antiretroviral Therapy From Sub-Saharan Africa, Europe, and Asia

Abstract

Keywords

UN SDGs

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