Anna E Coghill, Zachary Thompson, Laura Bamford, Greer Burkholder, Joseph Enron, Satish Gopal, Mari M Kitahata, Kenneth H Mayer, Richard Moore, George Yendewa, Brittney L Dickey, Elizabeth Yanik, Chad Achenbach
{"title":"在接受抗逆转录病毒治疗的患者中，免疫抑制和HIV控制与卡波西肉瘤的关系。","authors":"Anna E Coghill, Zachary Thompson, Laura Bamford, Greer Burkholder, Joseph Enron, Satish Gopal, Mari M Kitahata, Kenneth H Mayer, Richard Moore, George Yendewa, Brittney L Dickey, Elizabeth Yanik, Chad Achenbach","doi":"10.1097/QAD.0000000000004303","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Access to antiretroviral therapy (ART) has resulted in a decline in Kaposi sarcoma (KS) incidence among people with HIV (PWH). However, KS is still occurring among PWH receiving ART, and it is important to understand the degree to which risk of KS is impacted by response to ART.</p><p><strong>Methods: </strong>We examined the changing epidemiology of KS among >20,000 PWH receiving HIV care between 1996 and 2016 in the Center for AIDS Research Network of Integrated Clinical Systems (CNICS). We evaluated the association of KS with CD4 count and HIV viral load at ART initiation, within 6-12 months, and during clinical follow-up.</p><p><strong>Results: </strong>A total of 344 PWH were diagnosed with KS. CD4 count <200 cells/uL at ART initiation was associated with a >6-fold increased KS risk. Likewise, an HIV viral load >50,000 copies/mL at ART initiation was associated with a >3-fold increased KS risk. For every 100 cells/uL increase in CD4 count or log-unit decrease in HIV viral load during the 12-18 months after ART initiation, we observed 11% and 7% lower KS risks, respectively. During clinical follow-up after ART initiation, every 10% increase in time with a CD4 count >350 cells/uL or an HIV viral load <500 copies/mL was associated with 24% and 26% lower KS risks, respectively. All results reported here were statistically significant at the p < 0.05 threshold.</p><p><strong>Conclusion: </strong>KS risk among PWH receiving HIV care was significantly impacted by not only CD4 count and viral load at ART initiation, but also long-term suppression of HIV after ART initiation.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The association of immunosuppression and HIV control with Kaposi sarcoma among patients on antiretroviral therapy.\",\"authors\":\"Anna E Coghill, Zachary Thompson, Laura Bamford, Greer Burkholder, Joseph Enron, Satish Gopal, Mari M Kitahata, Kenneth H Mayer, Richard Moore, George Yendewa, Brittney L Dickey, Elizabeth Yanik, Chad Achenbach\",\"doi\":\"10.1097/QAD.0000000000004303\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Access to antiretroviral therapy (ART) has resulted in a decline in Kaposi sarcoma (KS) incidence among people with HIV (PWH). However, KS is still occurring among PWH receiving ART, and it is important to understand the degree to which risk of KS is impacted by response to ART.</p><p><strong>Methods: </strong>We examined the changing epidemiology of KS among >20,000 PWH receiving HIV care between 1996 and 2016 in the Center for AIDS Research Network of Integrated Clinical Systems (CNICS). We evaluated the association of KS with CD4 count and HIV viral load at ART initiation, within 6-12 months, and during clinical follow-up.</p><p><strong>Results: </strong>A total of 344 PWH were diagnosed with KS. CD4 count <200 cells/uL at ART initiation was associated with a >6-fold increased KS risk. Likewise, an HIV viral load >50,000 copies/mL at ART initiation was associated with a >3-fold increased KS risk. For every 100 cells/uL increase in CD4 count or log-unit decrease in HIV viral load during the 12-18 months after ART initiation, we observed 11% and 7% lower KS risks, respectively. During clinical follow-up after ART initiation, every 10% increase in time with a CD4 count >350 cells/uL or an HIV viral load <500 copies/mL was associated with 24% and 26% lower KS risks, respectively. All results reported here were statistically significant at the p < 0.05 threshold.</p><p><strong>Conclusion: </strong>KS risk among PWH receiving HIV care was significantly impacted by not only CD4 count and viral load at ART initiation, but also long-term suppression of HIV after ART initiation.</p>\",\"PeriodicalId\":7502,\"journal\":{\"name\":\"AIDS\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-07-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"AIDS\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/QAD.0000000000004303\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"AIDS","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/QAD.0000000000004303","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
The association of immunosuppression and HIV control with Kaposi sarcoma among patients on antiretroviral therapy.
Objective: Access to antiretroviral therapy (ART) has resulted in a decline in Kaposi sarcoma (KS) incidence among people with HIV (PWH). However, KS is still occurring among PWH receiving ART, and it is important to understand the degree to which risk of KS is impacted by response to ART.
Methods: We examined the changing epidemiology of KS among >20,000 PWH receiving HIV care between 1996 and 2016 in the Center for AIDS Research Network of Integrated Clinical Systems (CNICS). We evaluated the association of KS with CD4 count and HIV viral load at ART initiation, within 6-12 months, and during clinical follow-up.
Results: A total of 344 PWH were diagnosed with KS. CD4 count <200 cells/uL at ART initiation was associated with a >6-fold increased KS risk. Likewise, an HIV viral load >50,000 copies/mL at ART initiation was associated with a >3-fold increased KS risk. For every 100 cells/uL increase in CD4 count or log-unit decrease in HIV viral load during the 12-18 months after ART initiation, we observed 11% and 7% lower KS risks, respectively. During clinical follow-up after ART initiation, every 10% increase in time with a CD4 count >350 cells/uL or an HIV viral load <500 copies/mL was associated with 24% and 26% lower KS risks, respectively. All results reported here were statistically significant at the p < 0.05 threshold.
Conclusion: KS risk among PWH receiving HIV care was significantly impacted by not only CD4 count and viral load at ART initiation, but also long-term suppression of HIV after ART initiation.
期刊介绍：
Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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