Kaposi's Sarcoma Incidence Shows Dramatic Decline
Both protease inhibitor and non-nucleoside analog-based regimens have similar effect on Kaposi's sarcoma reduction
MONDAY, July 24 (HealthDay News) -- Combination antiretroviral therapy for HIV reduced HIV-associated Kaposi's sarcoma incidence from 32 per 1,000 per-years in 1993-1994 to three per 1,000 person-years in 1999, according to the results of a French study published in the July 20 issue of the Journal of Clinical Oncology. The effect is probably due to restoration of immune system function rather than from a specific effect from the drug regimen.
Sophie Grabar, M.D., Ph.D., of Hopital Cochin in Paris, France, and colleagues evaluated 54,999 HIV patients enrolled in the French Hospital Database on HIV, to study the impact of different combined antiretroviral regimens on Kaposi's sarcoma incidence.
Over 1,600 patients were diagnosed with Kaposi's sarcoma during follow-up but the overall incidence of Kaposi's sarcoma fell dramatically. Reductions were similar for both protease inhibitor- and non-nucleoside analog-based regimens (NNRTIs) and were especially strong for visceral Kaposi's sarcoma, involving the lungs, gastrointestinal tract and other organs, as opposed to cutaneous Kaposi's sarcoma.
"The incidence of Kaposi's sarcoma among HIV-infected patients, and especially the incidence of Kaposi's sarcoma with initial visceral involvement, has fallen drastically since the introduction of combined antiretroviral treatment," the authors conclude. "Protease inhibitors and NNRTIs appear to be equally effective in preventing Kaposi's sarcoma. Our results suggest that this preventive effect is due more to immune restoration induced by the treatment than to a class-specific effect."