Por favor, use este identificador para citar o enlazar este ítem:
https://www.arca.fiocruz.br/handle/icict/46397
Tipo
ArtículoDerechos de autor
Acceso restringido
Colecciones
- INI - Artigos de Periódicos [3460]
Metadatos
Mostrar el registro completo del ítem
ANTIRETROVIRAL THERAPY AND KAPOSI'S SARCOMA TRENDS AND OUTCOMES AMONG ADULTS WITH HIV IN LATIN AMERICA
Kaposi’s sarcoma
Latin America
Antiretroviral therapy
Incidence
Mortality
Autor
Castilho, Jessica L.
Kim, Ahra
Jenkins, Cathy A .
Grinsztejn, Beatriz
Gotuzzo, Eduardo
Fink, Valeria
Padgett, Denis
Belaunzaran-Zamudio, Pablo F.
Crabtree-Ramírez, Brenda
Escuder, Maria Mercedes
Souza, Rosa Alencar
Tenore, Simone B.
Pimentel, Sidnei R.
Ikeda, Maria Letícia Rodrigues
Alencastro, Paulo R. de
Tupinanbas, Unai
Brites, Carlos
Luz, Estela
Netto, Juliana
Cortes, Claudia P.
Grangeiro, Alexandre
Shepherd, Bryan E.
McGowan, Catherine C.
Caribbean, Central, South America network for HIV Epidemiology (CCASAnet)
Kim, Ahra
Jenkins, Cathy A .
Grinsztejn, Beatriz
Gotuzzo, Eduardo
Fink, Valeria
Padgett, Denis
Belaunzaran-Zamudio, Pablo F.
Crabtree-Ramírez, Brenda
Escuder, Maria Mercedes
Souza, Rosa Alencar
Tenore, Simone B.
Pimentel, Sidnei R.
Ikeda, Maria Letícia Rodrigues
Alencastro, Paulo R. de
Tupinanbas, Unai
Brites, Carlos
Luz, Estela
Netto, Juliana
Cortes, Claudia P.
Grangeiro, Alexandre
Shepherd, Bryan E.
McGowan, Catherine C.
Caribbean, Central, South America network for HIV Epidemiology (CCASAnet)
Afiliación
Vanderbilt University Medical Center. Division of Infectious Diseases. Nashville, TN, USA.
Vanderbilt University Medical Center. Department of Biostatistics. Nashville, TN, USA.
Vanderbilt University Medical Center. Department of Biostatistics. Nashville, TN, USA.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Universidad Peruana Cayetano Heredia. Instituto de Medicina Tropical Alexander von Humboldt. Lima, Peru.
Fundación Huésped. Investigaciones Clínicas. Buenos Aires, Argentina.
Instituto Hondureño de Seguridad Social and Hospital Escuela Universitario. Tegucigalpa, Honduras.
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Deparatmento de Infectologia. Mexico City, Mexico.
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Deparatmento de Infectologia. Mexico City, Mexico.
São Paulo State Department of Health. Institute of Health. São Paulo, SP, Brazil.
São Paulo State Department of Health. AIDS Reference and Training Center. São Paulo, SP, Brazil.
São Paulo State Department of Health. AIDS Reference and Training Center. São Paulo, SP, Brazil.
São Paulo State Department of Health. AIDS Reference and Training Center. São Paulo, SP, Brazil.
Rio Grande do Sul State Department of Health. Care and Treatment Clinic of the Partenon Sanatorium. Porto Alegre, RS, Brazil / University of Vale do Rio dos Sinos. São Leopoldo, RS, Brazil.
Rio Grande do Sul State Department of Health. Care and Treatment Clinic of the Partenon Sanatorium. Porto Alegre, RS, Brazil.
Federal University of Minas Gerais. Medical School. Belo Horizonte, BH, Brazil.
Federal University of Bahia. Edgar Santos University Hospital Complex. Salvador, BA, Brazil.
Federal University of Bahia. Edgar Santos University Hospital Complex. Salvador, BA, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Fundaciòn Arriaran and University of Chile School of Medicine. Santiago, Chile.
University of São Paulo School of Medicine. Department of Preventive Medicine. São Paulo, SP, Brazil.
Vanderbilt University Medical Center. Department of Biostatistics. Nashville, TN, USA.
Vanderbilt University Medical Center. Division of Infectious Diseases. Nashville, TN, USA.
Vanderbilt University Medical Center. Department of Biostatistics. Nashville, TN, USA.
Vanderbilt University Medical Center. Department of Biostatistics. Nashville, TN, USA.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Universidad Peruana Cayetano Heredia. Instituto de Medicina Tropical Alexander von Humboldt. Lima, Peru.
Fundación Huésped. Investigaciones Clínicas. Buenos Aires, Argentina.
Instituto Hondureño de Seguridad Social and Hospital Escuela Universitario. Tegucigalpa, Honduras.
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Deparatmento de Infectologia. Mexico City, Mexico.
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Deparatmento de Infectologia. Mexico City, Mexico.
São Paulo State Department of Health. Institute of Health. São Paulo, SP, Brazil.
São Paulo State Department of Health. AIDS Reference and Training Center. São Paulo, SP, Brazil.
São Paulo State Department of Health. AIDS Reference and Training Center. São Paulo, SP, Brazil.
São Paulo State Department of Health. AIDS Reference and Training Center. São Paulo, SP, Brazil.
Rio Grande do Sul State Department of Health. Care and Treatment Clinic of the Partenon Sanatorium. Porto Alegre, RS, Brazil / University of Vale do Rio dos Sinos. São Leopoldo, RS, Brazil.
Rio Grande do Sul State Department of Health. Care and Treatment Clinic of the Partenon Sanatorium. Porto Alegre, RS, Brazil.
Federal University of Minas Gerais. Medical School. Belo Horizonte, BH, Brazil.
Federal University of Bahia. Edgar Santos University Hospital Complex. Salvador, BA, Brazil.
Federal University of Bahia. Edgar Santos University Hospital Complex. Salvador, BA, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Fundaciòn Arriaran and University of Chile School of Medicine. Santiago, Chile.
University of São Paulo School of Medicine. Department of Preventive Medicine. São Paulo, SP, Brazil.
Vanderbilt University Medical Center. Department of Biostatistics. Nashville, TN, USA.
Vanderbilt University Medical Center. Division of Infectious Diseases. Nashville, TN, USA.
Resumen en ingles
Introduction: Kaposi's sarcoma (KS) remains the most frequent malignancy in persons living with HIV (PWH) in Latin America. We examined KS trends and outcomes from Latin American clinical sites in the era of increased access to antiretroviral therapy (ART).
Methods: Cohorts in Brazil, Peru, Mexico, Honduras, Argentina and Chile contributed clinical data of PWH ≥16 years old from 2000 to 2017, excluding patients with KS diagnosed before clinic enrolment. We compared KS incidence over time using multivariable incidence rate ratios. Predictors of KS before/at or after ART initiation and of mortality after KS were examined using Cox regression.
Results: Of 25 981 PWH, 481 had incident KS, including 200 ART-naïve and 281 ART-treated patients. From 2000 to 2017, the incidence of KS decreased from 55.1 to 3.0 per 1000 person-years. In models adjusting for CD4 and other factors, the relative risk for KS decreased from 2000 to 2008. Since 2010, the adjusted risk of KS increased in the periods before and ≤90 days after ART initiation but decreased >90 days after ART. In addition to low CD4 and male-to-male sex, KS risk after ART was associated with age and history of other AIDS-defining illnesses. Mortality after KS (approximately 25% after five years) was not associated with either year of KS diagnosis nor timing of diagnosis relative to ART initiation.
Conclusions: KS incidence in Latin America has remained stable in recent years and risk is highest before and shortly after ART initiation. Early diagnosis of HIV and ART initiation remain critical priorities in the region.
Palabras clave en ingles
HIVKaposi’s sarcoma
Latin America
Antiretroviral therapy
Incidence
Mortality
Compartir