Comparison of Kaposi Sarcoma Risk in Human Immunodeficiency Virus-Positive Adults Across 5 Continents: A Multiregional Multicohort Study

Rohner, Eliane; Bütikofer, Lukas; Schmidlin, Kurt; Sengayi, Mazvita; Maskew, Mhairi; Giddy, Janet; Garone, Daniela; Moore, Richard D.; D’Souza, Gypsyamber; Goedert, James J.; Achenbach, Chad; Gill, M. John; Kitahata, Mari M.; Patel, Pragna; Silverberg, Michael J.; Castilho, Jessica L; McGowan, Catherine C.; Chen, Yi Ming Arthur; Law, Matthew; Taylor, Ninon; Paparizos, Vassilios; Bonnet, Fabrice; Verbon, Annelies; Fätkenheuer, Gerd; Post, Frank A.; Sabin, Caroline; Mocrof, Amanda; Moing, Vincent Le; Dronda, Fernando; Obel, Niels; Grabar, Sophie; Spagnuolo, Vincenzo; Antinori, Andrea; Quiros-Roldan, Eugenia; Mussini, Cristina; Miró, José M.; Meyer, Laurence; Hasse, Barbara; Konopnicki, Déborah; Roca, Bernardino; Barger, Diana; Raben, Dorthe; Cliford, Gary M.; Franceschi, Silvia; Brockmeyer, Norbert H.; Chakraborty, Rana; Egger, Matthias; Bohlius, Julia

doi:10.1093/cid/cix480

Cited by 44 publications

(28 citation statements)

References 34 publications

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“…The effect of cART on the incidence of AIDS-related KS in sub-Saharan Africa is difficult to quantify because fewer data are available 34,35 . A 2017 study, based on over 200,000 patients, reported raw KS incidence per 100,000 person-years in 42 cohorts from 57 countries, including North America (237 per 100,000 person-years), Latin America (244 per 100,000 person-years), Europe (180 per 100,000 person- years), Asia-Pacific (52 per 100,000 person-years) and South Africa (280 per 100,000 person-years) 36 . KS risk was approximately two times higher in heterosexual men than in women and six times higher in MSM than in women 36 .…”

Section: Epidemiologymentioning

confidence: 99%

Kaposi sarcoma

Cesarman

Damania

Krown³

et al. 2019

Nat Rev Dis Primers

415

510

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Kaposi sarcoma (KS) gained public attention as an AIDS-defining malignancy; its appearance on the skin was a highly stigmatizing sign of HIV infection during the height of the AIDS epidemic. The widespread introduction of effective antiretrovirals to control HIV by restoring immunocompetence reduced the prevalence of AIDS-related KS, although KS does occur in individuals with well-controlled HIV infection. KS also presents in individuals without HIV infection in older men (classic KS), in sub-Saharan Africa (endemic KS) and in transplant recipients (iatrogenic KS). The aetiologic agent of KS is KS herpesvirus (KSHV; also known as human herpesvirus-8), and viral proteins can induce KS-associated cellular changes that enable the virus to evade the host immune system and allow the infected cell to survive and proliferate despite viral infection. Currently, most cases of KS occur in sub-Saharan Africa, where KSHV infection is prevalent owing to transmission by saliva in childhood compounded by the ongoing AIDS epidemic. Treatment for early AIDS-related KS in previously untreated patients should start with the control of HIV with antiretrovirals, which frequently results in KS regression. In advanced-stage KS, chemotherapy with pegylated liposomal doxorubicin or paclitaxel is the most common treatment, although it is seldom curative. In sub-Saharan Africa, KS continues to have a poor prognosis. Newer treatments for KS based on the mechanisms of its pathogenesis are being explored.

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Section: Epidemiologymentioning

confidence: 99%

Kaposi sarcoma

Cesarman

Damania

Krown³

et al. 2019

Nat Rev Dis Primers

415

510

View full text Add to dashboard Cite

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“…Antiretroviral therapy effectively decreases KS incidence [7] and the presence of KSHV in oral cells [8]. However, even in the era of combination antiretroviral therapy (cART), KS remains one of the most common AIDS-related cancers in the United States and throughout sub-Saharan Africa [9]. Upon initiation of cART, KS can also progress, possibly triggered by, or exacerbated by a KS immune reconstitution inflammatory syndrome (IRIS) [10].…”

Section: Introductionmentioning

confidence: 99%

Signatures of oral microbiome in HIV-infected individuals with oral Kaposi's sarcoma and cell-associated KSHV DNA

et al. 2020

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Infection by Kaposi's sarcoma-associated herpesvirus (KSHV) is necessary for the development of Kaposi's sarcoma (KS), which most often develops in HIV-infected individuals. KS frequently has oral manifestations and KSHV DNA can be detected in oral cells. Numerous types of cancer are associated with the alteration of microbiome including bacteria and virus. We hypothesize that oral bacterial microbiota affects or is affected by oral KS and the presence of oral cell-associated KSHV DNA. In this study, oral and blood specimens were collected from a cohort of HIV/KSHV-coinfected individuals all previously diagnosed with KS, and were classified as having oral KS with any oral cell-associated KSHV DNA status (O-KS, n = 9), no oral KS but with oral cell-associated KSHV DNA (O-KSHV, n = 10), or with neither oral KS nor oral cell-associated KSHV DNA (No KSHV, n = 10). We sequenced the hypervariable V1-V2 region of the 16S rRNA gene present in oral cell-associated DNA by next generation sequencing. The diversity, richness, relative abundance of operational taxonomic units (OTUs) and taxonomic composition of oral microbiota were analyzed and compared across the 3 studied groups. We found impoverishment of oral microbial diversity and enrichment of specific microbiota in O-KS individuals compared to O-KSHV or No KSHV individuals. These results suggest that HIV/KSHV coinfection and oral microbiota might impact one another and influence the development of oral KS.

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“…However, in North America and Europe, although reporting of KS was lower than in South Africa, men had a high-risk of KS acquisition. In contrast, incidence of KS was very low in the Asia-Pacific regions7.…”

mentioning

confidence: 98%

“…However, this study also recommended the need for more data from diverse settings to bridge knowledge gaps such as effectiveness of ART at an individual patient level as well as at the population level21. The scenario remains challenging in Africa where high burden of KS persists probably due to inadequate access to health care and high HHV-8 co-infection rates720. Ideally, models should be developed for predicting the susceptibility of HIV-infected people to KS based on access to care and ART in various geographic settings and varied economies.…”

mentioning

confidence: 99%

“…It is believed that the risk of KS among HIV-infected individuals varies geographically, probably due to differences in prevalence of HHV-8, HIV burden, local drivers of the HIV epidemic and access to care for the populations at risk of HIV infection. A recent multicentre multiregional analysis in the Asia-Pacific, South Africa, Europe, Latin and North America regions provided data on risk of KS7. The study reported that the risk of KS was highest in South Africa with cases reported even in women.…”

mentioning

confidence: 99%

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