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Age patterns of Kaposi's sarcoma incidence in a cohort of HIV-infected men

H. N. Luu,E. Amirian,Elizabeth Y. Chiao,Michael E. Scheurer

Published 2014 in Cancer Medicine

ABSTRACT

The life expectancy for HIV‐positive individuals has improved over time due to increasing access to highly active antiretroviral therapy (HAART). Yet, as the HIV‐positive population ages, their risk of developing cancers also increases. Studies of Kaposi's sarcoma (KS) among elderly HIV‐infected persons are quite limited. We examined the age patterns of KS incidence and an association between age and KS risk in a US cohort of 3458 HIV‐infected men, the Multicenter AIDS Cohort Study (MACS). Poisson distribution was used to calculate incidence rates and respective 95% confidence intervals (95% CIs). Cox proportional hazards regression was performed to examine the association between age and KS risk. There were 534 incident KS cases with a total follow‐up time of 25,134 person‐years. The overall KS incidence rate was 2.13 per 100 person‐years (95% CI: 1.95–2.32) (Non‐HAART users‐ever: 5.57 per 100 person‐years [95% CI: 5.09–6.10]; HAART users‐ever: 0.39 per 100 person‐years [95% CI: 0.31–0.51]). Overall, KS frequency and incidence declined with age, even in the oldest age group (ptrend < 0.0001). However, among non‐HAART users‐ever, the oldest age group had the highest incidence rate ratio compared to younger individuals [15.01, 95% CI: 6.12–44.22]). While the incidence of KS decreased with age, older HIV‐infected persons who do not receive HAART are still at increased risk of KS. As KS remains an important malignancy among HIV‐infected persons, earlier HIV diagnoses and HAART initiation, particularly in older HIV‐infected persons is warranted.

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