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Antiretroviral Therapy for HIV-Associated Cutaneous Kaposi's Sarcoma: Clinical, HIV-Related, and Sociodemographic Predictors of Outcome
AIDS Research and Human Retroviruses ( IF 1.5 ) Pub Date : 2021-04-29 , DOI: 10.1089/aid.2020.0099 Owen Ngalamika 1 , Sody Munsaka 2 , Salum J Lidenge 3, 4, 5, 6 , John T West 5, 7 , Charles Wood 5, 6, 7
AIDS Research and Human Retroviruses ( IF 1.5 ) Pub Date : 2021-04-29 , DOI: 10.1089/aid.2020.0099 Owen Ngalamika 1 , Sody Munsaka 2 , Salum J Lidenge 3, 4, 5, 6 , John T West 5, 7 , Charles Wood 5, 6, 7
Affiliation
Kaposi's sarcoma (KS) is an AIDS-defining malignancy that can improve or worsen with antiretroviral therapy (ART). We aimed at identifying clinical, HIV-related, and sociodemographic factors associated with either progression or nonprogression (regression or stable disease) of ART-treated HIV-associated KS in patients with limited cutaneous disease. We conducted a prospective cohort study of ART-treated HIV-associated KS cases. Clinical, HIV-related, and sociodemographic variables were collected at baseline, and patients were followed up to determine treatment outcomes. Cox regression, linear mixed effects model, and Spearman's rank correlation were used for analysis. Half (50%) of the study participants had KS regression or stable disease, whereas the other half (50%) had disease progression during the treatment and follow-up period. Among the data analyzed, presence of KS nodules at baseline (hazard ratio = 5.47; 95% confidence interval = 1.32–22.65; p = .02) was an independent predictor of poor treatment outcome. Progressors and nonprogressors were indistinguishable in the changes they experienced in the HIV plasma viral load and CD4 counts as a result of ART. Even when cutaneous presentation is limited, the presence of nodular morphotype KS lesions should be considered an indicator for combined ART plus chemotherapy. Temporal trends in CD4 counts and HIV viral loads did not correlate with treatment outcome in ART-treated HIV-associated KS.
中文翻译:
HIV 相关皮肤卡波西肉瘤的抗逆转录病毒疗法:临床、HIV 相关和社会人口学结果的预测因子
卡波西肉瘤 (KS) 是一种定义为艾滋病的恶性肿瘤,可以通过抗逆转录病毒疗法 (ART) 改善或恶化。我们的目的是确定与有限皮肤病患者接受 ART 治疗的 HIV 相关 KS 进展或非进展(疾病消退或疾病稳定)相关的临床、HIV 相关和社会人口学因素。我们对接受 ART 治疗的 HIV 相关 KS 病例进行了一项前瞻性队列研究。在基线收集临床、HIV 相关和社会人口学变量,并对患者进行随访以确定治疗结果。使用 Cox 回归、线性混合效应模型和 Spearman 等级相关进行分析。一半 (50%) 的研究参与者出现 KS 消退或疾病稳定,而另一半 (50%) 在治疗和随访期间出现疾病进展。p = .02) 是不良治疗结果的独立预测因子。由于 ART,进展者和非进展者在 HIV 血浆病毒载量和 CD4 计数方面所经历的变化无法区分。即使皮肤表现有限,结节型 KS 病变的存在也应被视为联合 ART 加化疗的指标。CD4 计数和 HIV 病毒载量的时间趋势与 ART 治疗的 HIV 相关 KS 的治疗结果无关。
更新日期:2021-05-06
中文翻译:
HIV 相关皮肤卡波西肉瘤的抗逆转录病毒疗法:临床、HIV 相关和社会人口学结果的预测因子
卡波西肉瘤 (KS) 是一种定义为艾滋病的恶性肿瘤,可以通过抗逆转录病毒疗法 (ART) 改善或恶化。我们的目的是确定与有限皮肤病患者接受 ART 治疗的 HIV 相关 KS 进展或非进展(疾病消退或疾病稳定)相关的临床、HIV 相关和社会人口学因素。我们对接受 ART 治疗的 HIV 相关 KS 病例进行了一项前瞻性队列研究。在基线收集临床、HIV 相关和社会人口学变量,并对患者进行随访以确定治疗结果。使用 Cox 回归、线性混合效应模型和 Spearman 等级相关进行分析。一半 (50%) 的研究参与者出现 KS 消退或疾病稳定,而另一半 (50%) 在治疗和随访期间出现疾病进展。p = .02) 是不良治疗结果的独立预测因子。由于 ART,进展者和非进展者在 HIV 血浆病毒载量和 CD4 计数方面所经历的变化无法区分。即使皮肤表现有限,结节型 KS 病变的存在也应被视为联合 ART 加化疗的指标。CD4 计数和 HIV 病毒载量的时间趋势与 ART 治疗的 HIV 相关 KS 的治疗结果无关。