Pulmonary Kaposi sarcoma in the era of highly active antiretroviral therapy
Pulmonary Kaposi sarcoma in the era of highly active antiretroviral therapy
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DOI：
10.1111/j.1468-1293.2006.00378.x
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发表时间：
2006-07-01
期刊：
影响因子：
3
通讯作者：
Bower, M.
中科院分区：
文献类型：
--
作者：
Palmieri, C.;Dhillon, T.;Bower, M.
目的自高效抗逆转录病毒治疗（HAART）以来，Kaposi肉瘤（KS）的发病率显著降低，生存率提高。我们希望研究是否在肺KS（pKS）的结果也altered.Methods在一个单一的机构队列的1140艾滋病毒阳性患者KS，305例患者被诊断在HAART时代（1996-2004年）。我们研究了这些患者的临床病理特征和结果，其中25 pKS和280没有。结果pKS患者有较低的CD 4细胞计数在KS诊断的时间（Mann-Whitney U检验P=0.005）。在该样本中，非洲患者的pKS发生率高于非非洲患者（Fisher检验，P=0.001）。在KS诊断时，年龄、性别、血浆HIV-1病毒载量或既往HAART治疗无显著差异。pKS组5年总生存率为49%（95%CI 26-73%），非pKS组为82%（95%CI 76-87%）（logrank，P < 0.0001）。
Objective Since the introduction of highly active antiretroviral therapy (HAART) there has been a dramatic reduction in the incidence of Kaposi sarcoma (KS) and an improvement in survival. We wished to examine whether the outcome in pulmonary KS (pKS) has also altered.Methods In a single-institution cohort of 1140 HIV-positive patients with KS, 305 patients were diagnosed in the HAART era (1996-2004). We examined the clinicopathological features and outcomes of these patients, of whom 25 had pKS and 280 did not.Results Patients with pKS had lower CD4 cell counts at the time of KS diagnosis (Mann-Whitney U-test P=0.005). The incidence of pKS was higher in African patients than in non-African patients in this sample (Fisher's test, P=0.001). There were no significant differences in age, gender, plasma HIV-1 viral load or prior HAART treatment at the time of KS diagnosis. Five-year overall survival in the pKS group was 49% [95% confidence interval (CI) 26-73%] as compared with 82% (95% CI 76-87%) for the non-pKS group (log rank, P < 0.0001).Conclusion PKS remains an ominous diagnosis in the era of HAART, with a median survival of just 1.6 years.