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Meta-Analysis
. 2018 May;19(5):355-364.
doi: 10.1111/hiv.12584. Epub 2018 Jan 25.

The world-wide incidence of Kaposi's sarcoma in the HIV/AIDS era

Z Liu  1   2 , Q Fang  1   2 , J Zuo  1   2 , V Minhas  3 , C Wood  3 , T Zhang  1   2
Affiliations
Free article
Meta-Analysis

The world-wide incidence of Kaposi's sarcoma in the HIV/AIDS era

Z Liu et al. HIV Med. 2018 May.
Free article

Abstract

Objectives: Kaposi's sarcoma (KS) is a multicentric angioproliferative cancer of endothelial origin typically occurring in the context of immunosuppression or immunodeficiency. Consequently, KS is one of the most common cancers in HIV-infected individuals and frequently occurs among transplant recipients. Nevertheless, its incidence in different populations is not well understood.

Methods: We searched online databases for publications on KS incidence. A random-effect meta-analysis was performed to combine the KS incidences and incidence rate ratios (IRRs) for associated risk factors.

Results: Seventy-six eligible studies representing 71 time periods were included. For HIV-infected people, the overall KS incidence was 481.54 per 100 000 person-years with a 95% confidential interval (CI) of 342.36-677.32 per 100 000 person-years. HIV-infected men who have sex with men (MSM) had the highest incidence of KS (1397.11 per 100 000 person-years; 95% CI 870.55-2242.18 per 100 000 person-years). The incidence of KS was significantly lower in female than in male individuals (IRR 3.09; 95% CI 1.70-5.62). People receiving highly active antiretroviral therapy (HAART) had a lower incidence compared with people who had never received HAART (IRR 6.57; 95% CI 1.91-24.69). The incidence of KS was 68.59 (95% CI 31.39-149.86) per 100 000 person-years in transplant recipients, 52.94 (95% CI 39.90-70.20) per 100 000 person-years in children with HIV infection, and 1.53 (95% CI 0.33-7.08) per 100 000 person-years in the general population.

Conclusions: Globally, a relatively high incidence of KS was found among HIV-seropositive people and, in particular, in HIV-infected MSM. The introduction of HAART has largely prevented the development of KS, but it has not entirely removed the challenge of KS. In Africa, in particular, KS imposes a very heavy disease burden, which can mainly be attributed to the high prevalence of KS-associated herpesvirus and poor access to HAART.

Keywords: HIV/AIDS; Kaposi's sarcoma; incidence; meta-analysis.

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