Despite the overall national decline in Kaposi Sarcoma (KS) incidence in the US among persons living with HIV, previous studies suggest there might be specific subgroups of the US population that are associated with higher KS incidence rates than others. Using the 2001-2018 National Program of Cancer Registries and Surveillance, Epidemiology, and End Results Program Database, we assessed KS incidence trends among young men aged 20-34 by race and ethnicity and geographic region. Statistical significance is 2-sided. The KS incidence rate increased nationally by 1.5%/year in non-Hispanic Black men, while the rate decreased significantly by 3.5%/year in non-Hispanic White men. A significant 3.3%/year increase among young non-Hispanic Black men in the South and no change among those living in non-South regions were observed. Targeted HIV prevention and treatment in young non-Hispanic Black men in the South and further research addressing the increased KS incidence and burden in this vulnerable population are needed.
Objective:To describe risk factors for mortality in HIV-associated Kaposi's sarcoma in an urban population in Dallas, Texas.Design:Retrospective electronic medical record review of patients with HIV-associated Kaposi's sarcoma.Methods:Electronic medical records were reviewed from 1 January 2009 to 31 December 2018 for patients with a diagnosis of HIV and Kaposi's sarcoma by ICD-9 or ICD-10 codes. Demographics, HIV history, Kaposi's sarcoma history, treatment, and mortality data were collected. Mortality data was supplemented by an inquiry from the National Death Index (NDI). Survival analyses were performed using Cox proportional hazards analysis to determine independent predictors of mortality.Results:Black patients had higher mortality than white or Hispanic patients (hazard ratio 2.07, 95% confidence interval 1.12–3.82), even after adjusting for covariates. This mortality difference correlates with higher rates of advanced Kaposi's sarcoma disease and KS-IRIS in black patients compared with other groups and is not explained by differences in CD4+ cell count, HIV viral load, engagement in care, or ART adherence at the time of cancer diagnosis.Conclusion:Despite nationwide trends showing decreased incidence and decreased mortality in Kaposi's sarcoma in the ART era, a high number of Kaposi's sarcoma cases and disparities in Kaposi's sarcoma outcomes persist in certain populations in the United States.
The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. The named authors alone are responsible for the views expressed in this publication. WHO Library Cataloguing-in-Publication Data Brucellosis in humans and animals. Produced by the World Health Organization in collaboration with the Food and Agriculture Organization of the United Nations and World Organisation for Animal Health Principal author: M.J. Corbel. 1.Brucellosis-prevention and control. 2.Brucellosis-epidemiology. 3.Brucellosis-complications. 4.Guidelines. I.Corbel, M.J. II.World Health Organization. III.Food and Agriculture Organization of the United Nations. IV.World Organisation for Animal Health. ISBN 92 4 154713 8 (NLM classification: WC 310) ISBN 978 92 4 154713 0 i i i Contents Contents Contents Contents Contents
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