Risk factors for Kaposi's sarcoma in human immunodeficiency virus patients after initiation of antiretroviral therapy: A nested case-control study in Kenya

Rodgers Lupia, Peter B. Wabuyia, Peter Otiato, Chi Tai Fang, Feng Jen Tsai

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5 Citations (Scopus)

Abstract

Background/Purpose: This study aimed to evaluate the association between highly active antiretroviral therapy (HAART) adherence and development of Kaposi's sarcoma (KS) in human immunodeficiency virus (HIV)/AIDS patients. Methods: We conducted a retrospective nested case-control study of 165 participants (33 cases and 132 controls) receiving HAART care at Maseno Hospital, Kenya, from January 2005 to October 2013. Cases were HIV-positive adults with KS, who were matched with controls in a ratio of 1:4 based on age (±5 years of each case), sex, and KS diagnosis date. Perfect adherence to HAART was assessed on every clinic visit by patients' self-reporting and pill counts. Chi-square tests were performed to compare socioeconomic and clinical statuses between cases and controls. A conditional logistic regression was used to assess the effects of perfect adherence to HAART, the latest CD4 count, education level, distance to health-care facility, initial World Health Organization stage, and number of regular sexual partners on the development of KS. Results: Only 63.6% participants reported perfect adherence, and the control group had a significantly higher percentage of perfect adherence (75.0%) than did cases (18.2%). After adjustment for potential imbalances in the baseline and clinical characteristics, patients with imperfect HAART adherence had 20-times greater risk of developing KS than patients with perfect HAART adherence [hazard ratios: 21.0, 95% confidence interval: 4.2-105.1]. Patients with low latest CD4 count (≤350 cells/mm3) had a seven-times greater risk of developing KS than did their counterparts (HRs: 7.1, 95% CI: 1.4-36.2). Conclusion: Imperfect HAART adherence and low latest CD4 count are significantly associated with KS development.

Original languageEnglish
JournalJournal of Microbiology, Immunology and Infection
DOIs
Publication statusAccepted/In press - Jul 3 2015

Fingerprint

Kaposi's Sarcoma
Kenya
Highly Active Antiretroviral Therapy
Case-Control Studies
HIV
CD4 Lymphocyte Count
Therapeutics
Distance Education
Sexual Partners
Health Facilities
Chi-Square Distribution
Ambulatory Care
Social Class
Acquired Immunodeficiency Syndrome
Logistic Models
Confidence Intervals
Delivery of Health Care
Control Groups

Keywords

  • Antiretroviral therapy
  • Highly active antiretroviral therapy
  • Human immunodeficiency virus/AIDS treatment
  • Kaposi's sarcoma
  • Kenya
  • Maseno

ASJC Scopus subject areas

  • Microbiology (medical)
  • Immunology and Allergy
  • Immunology and Microbiology(all)
  • Infectious Diseases

Cite this

@article{2b3c6d6d1b7049b191439ea2db6b20a7,
title = "Risk factors for Kaposi's sarcoma in human immunodeficiency virus patients after initiation of antiretroviral therapy: A nested case-control study in Kenya",
abstract = "Background/Purpose: This study aimed to evaluate the association between highly active antiretroviral therapy (HAART) adherence and development of Kaposi's sarcoma (KS) in human immunodeficiency virus (HIV)/AIDS patients. Methods: We conducted a retrospective nested case-control study of 165 participants (33 cases and 132 controls) receiving HAART care at Maseno Hospital, Kenya, from January 2005 to October 2013. Cases were HIV-positive adults with KS, who were matched with controls in a ratio of 1:4 based on age (±5 years of each case), sex, and KS diagnosis date. Perfect adherence to HAART was assessed on every clinic visit by patients' self-reporting and pill counts. Chi-square tests were performed to compare socioeconomic and clinical statuses between cases and controls. A conditional logistic regression was used to assess the effects of perfect adherence to HAART, the latest CD4 count, education level, distance to health-care facility, initial World Health Organization stage, and number of regular sexual partners on the development of KS. Results: Only 63.6{\%} participants reported perfect adherence, and the control group had a significantly higher percentage of perfect adherence (75.0{\%}) than did cases (18.2{\%}). After adjustment for potential imbalances in the baseline and clinical characteristics, patients with imperfect HAART adherence had 20-times greater risk of developing KS than patients with perfect HAART adherence [hazard ratios: 21.0, 95{\%} confidence interval: 4.2-105.1]. Patients with low latest CD4 count (≤350 cells/mm3) had a seven-times greater risk of developing KS than did their counterparts (HRs: 7.1, 95{\%} CI: 1.4-36.2). Conclusion: Imperfect HAART adherence and low latest CD4 count are significantly associated with KS development.",
keywords = "Antiretroviral therapy, Highly active antiretroviral therapy, Human immunodeficiency virus/AIDS treatment, Kaposi's sarcoma, Kenya, Maseno, Antiretroviral therapy, Highly active antiretroviral therapy, Human immunodeficiency virus/AIDS treatment, Kaposi's sarcoma, Kenya; Maseno",
author = "Rodgers Lupia and Wabuyia, {Peter B.} and Peter Otiato and Fang, {Chi Tai} and Tsai, {Feng Jen}",
year = "2015",
month = "7",
day = "3",
doi = "10.1016/j.jmii.2015.10.009",
language = "English",
journal = "Journal of Microbiology, Immunology and Infection",
issn = "0253-2662",
publisher = "Elsevier Taiwan LLC",

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TY - JOUR

T1 - Risk factors for Kaposi's sarcoma in human immunodeficiency virus patients after initiation of antiretroviral therapy

T2 - A nested case-control study in Kenya

AU - Lupia, Rodgers

AU - Wabuyia, Peter B.

AU - Otiato, Peter

AU - Fang, Chi Tai

AU - Tsai, Feng Jen

PY - 2015/7/3

Y1 - 2015/7/3

N2 - Background/Purpose: This study aimed to evaluate the association between highly active antiretroviral therapy (HAART) adherence and development of Kaposi's sarcoma (KS) in human immunodeficiency virus (HIV)/AIDS patients. Methods: We conducted a retrospective nested case-control study of 165 participants (33 cases and 132 controls) receiving HAART care at Maseno Hospital, Kenya, from January 2005 to October 2013. Cases were HIV-positive adults with KS, who were matched with controls in a ratio of 1:4 based on age (±5 years of each case), sex, and KS diagnosis date. Perfect adherence to HAART was assessed on every clinic visit by patients' self-reporting and pill counts. Chi-square tests were performed to compare socioeconomic and clinical statuses between cases and controls. A conditional logistic regression was used to assess the effects of perfect adherence to HAART, the latest CD4 count, education level, distance to health-care facility, initial World Health Organization stage, and number of regular sexual partners on the development of KS. Results: Only 63.6% participants reported perfect adherence, and the control group had a significantly higher percentage of perfect adherence (75.0%) than did cases (18.2%). After adjustment for potential imbalances in the baseline and clinical characteristics, patients with imperfect HAART adherence had 20-times greater risk of developing KS than patients with perfect HAART adherence [hazard ratios: 21.0, 95% confidence interval: 4.2-105.1]. Patients with low latest CD4 count (≤350 cells/mm3) had a seven-times greater risk of developing KS than did their counterparts (HRs: 7.1, 95% CI: 1.4-36.2). Conclusion: Imperfect HAART adherence and low latest CD4 count are significantly associated with KS development.

AB - Background/Purpose: This study aimed to evaluate the association between highly active antiretroviral therapy (HAART) adherence and development of Kaposi's sarcoma (KS) in human immunodeficiency virus (HIV)/AIDS patients. Methods: We conducted a retrospective nested case-control study of 165 participants (33 cases and 132 controls) receiving HAART care at Maseno Hospital, Kenya, from January 2005 to October 2013. Cases were HIV-positive adults with KS, who were matched with controls in a ratio of 1:4 based on age (±5 years of each case), sex, and KS diagnosis date. Perfect adherence to HAART was assessed on every clinic visit by patients' self-reporting and pill counts. Chi-square tests were performed to compare socioeconomic and clinical statuses between cases and controls. A conditional logistic regression was used to assess the effects of perfect adherence to HAART, the latest CD4 count, education level, distance to health-care facility, initial World Health Organization stage, and number of regular sexual partners on the development of KS. Results: Only 63.6% participants reported perfect adherence, and the control group had a significantly higher percentage of perfect adherence (75.0%) than did cases (18.2%). After adjustment for potential imbalances in the baseline and clinical characteristics, patients with imperfect HAART adherence had 20-times greater risk of developing KS than patients with perfect HAART adherence [hazard ratios: 21.0, 95% confidence interval: 4.2-105.1]. Patients with low latest CD4 count (≤350 cells/mm3) had a seven-times greater risk of developing KS than did their counterparts (HRs: 7.1, 95% CI: 1.4-36.2). Conclusion: Imperfect HAART adherence and low latest CD4 count are significantly associated with KS development.

KW - Antiretroviral therapy

KW - Highly active antiretroviral therapy

KW - Human immunodeficiency virus/AIDS treatment

KW - Kaposi's sarcoma

KW - Kenya

KW - Maseno

KW - Antiretroviral therapy

KW - Highly active antiretroviral therapy

KW - Human immunodeficiency virus/AIDS treatment

KW - Kaposi's sarcoma

KW - Kenya; Maseno

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U2 - 10.1016/j.jmii.2015.10.009

DO - 10.1016/j.jmii.2015.10.009

M3 - Article

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JO - Journal of Microbiology, Immunology and Infection

JF - Journal of Microbiology, Immunology and Infection

SN - 0253-2662

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