Abstract

Kaposi Sarcoma in a cohort of patients with HIV/AIDS in Rio de Janeiro, Brazil

Presented by Juliana Netto (Brazil).

J. Netto, L. Coelho, C. Cunha, S. Ribeiro, V.G. Veloso, B. Grinsztejn

Fundação Oswaldo Cruz, Instituto de Pesquisa Clínica Evandro Chagas, Rio de Janeiro, Brazil

Background: Kaposi Sarcoma (KS), a potentially life-threatening multifocal neoplasm, is the most common AIDS-associated malignancy and remains an important cause of morbidity and mortality. The incidence of KS has declined significantly in HIV positive populations with access to HAART. We performed a study to evaluate the clinical outcomes of patients diagnosed with AIDS-related KS.
Methods: We collected epidemiologic, clinical, staging, and outcomes from all patients with AIDS-KS enrolled in the IPEC-Fiocruz HIV Clinical Cohort, a referral center for care and research located Rio de Janeiro, Brazil from 1987 to 2008. All patients with the diagnosis of KS made from January 1987 to December 2008 were included in this analysis.
Results: One hundred twenty five (125) patients were diagnosed with KS, 92% male. Mean age at KS diagnosis was 37.3 years and average duration of known HIV seropositivity was 44 months. 57% of the cases occurred after 1997, when HAART became available through universal access in Brazil. At KS diagnosis, 38.3 patients were ARV naïve and 42.6% were on ART and 50% of these on HAART. Overall, 60.2% patients had stage T0 disease and 39.8% had stage T1 disease at KS diagnosis. In the HAART era, 53.2 % patients had stage T0 disease and 46.8% had stage T1 disease at KS diagnosis. Thirty one (41, 3%) patients died of KS. Median survival after KS diagnosis was 14 months. Outcomes were as follows: 58.4% died, 29.6% were cured and 10,4 were lost to follow up.
Conclusions: Despite HAART availability in Brazil, KS remains an important cause of morbidity and associated mortality. Diagnosis with advanced disease is still common and a high proportion on patients required parenteral chemotherapy for their management. Health services planning for HIV/AIDS patients must take these needs into consideration.
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