scholarly journals Feasibility of Rapid Case Ascertainment for Cancer in East Africa: An Investigation of Community-Representative Kaposi Sarcoma in the Era of Antiretroviral Therapy

2021 ◽  
Vol 74 ◽  
pp. 101997
Author(s):  
Aggrey Semeere ◽  
Helen Byakwaga ◽  
Miriam Laker-Oketta ◽  
Esther Freeman ◽  
Naftali Busakhala ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
East Africa ◽  
Kaposi Sarcoma ◽  
Case Ascertainment ◽  
Community Representative

scholarly journals Feasibility of Rapid Case Ascertainment for Cancer in East Africa: An Investigation of Community-Representative Kaposi Sarcoma in the Era of Antiretroviral Therapy.

2021 ◽  
Author(s):  
Aggrey Semeere ◽  
Helen Byakwaga ◽  
Miriam Laker-Oketta ◽  
Esther Freeman ◽  
Naftali Busakhala ◽  
...  
Keyword(s):  
Cancer Research ◽  
East Africa ◽  
Kaposi Sarcoma ◽  
Detailed Examination ◽  
Sub Saharan Africa ◽  
Case Ascertainment ◽  
Community Representative ◽  
Resource Limited ◽  
Sub Saharan ◽  
Record Review

BACKGROUND: Rapid case ascertainment (RCA) refers to the expeditious and detailed examination of patients with a potentially rapidly fatal disease shortly after diagnosis. RCA is frequently performed in resource-rich settings to facilitate cancer research. Despite its utility, RCA is rarely implemented in resource-limited settings and has not been performed for malignancies. One cancer and context that would benefit from RCA in a resource-limited setting is HIV-related Kaposi sarcoma (KS) in sub-Saharan Africa. METHODS: To determine the feasibility of RCA of KS, we searched for all potential newly diagnosed KS among HIV-infected adults attending three community-based facilities in Uganda and Kenya. Searching involved querying of electronic medical records, pathology record review, and notification by clinicians. Upon identification, a team verified eligibility and attempted to locate patients to perform RCA, which included epidemiologic, clinical and laboratory measurements. RESULTS: We identified 593 patients with suspected new KS. Of the 593, 171 were ineligible, mainly because biopsy failed to confirm KS (65%) or KS was not new (30%). Among the 422 remaining, RCA was performed within 1 month for 56% of patients and within 3 months for 65% (95% confidence interval: 59 to 70%). Reasons for not performing RCA included intervening death (47%), inability to contact (44%), refusal/unsuitable to consent (8.3%), and patient re-location (0.7%). CONCLUSIONS: We found that RCA, an important tool for cancer research in resource-rich settings, is feasible for the investigation of community-representative KS in East Africa. Feasibility of RCA for KS suggests feasibility for other cancers in Africa.

scholarly journals Persistent Kaposi sarcoma in the era of highly active antiretroviral therapy: characterizing the predictors of clinical response

AIDS ◽  
2008 ◽  
Vol 22 (8) ◽  
pp. 937-945 ◽  
Author(s):  
Huong Q Nguyen ◽  
Amalia S Magaret ◽  
Mari M Kitahata ◽  
Stephen E Van Rompaey ◽  
Anna Wald ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Clinical Response ◽  
Highly Active Antiretroviral Therapy ◽  
Kaposi Sarcoma ◽  
Highly Active

Interferon-??2b With Protease Inhibitor-Based Antiretroviral Therapy in Patients With AIDS-Associated Kaposi Sarcoma

2006 ◽  
Vol 41 (2) ◽  
pp. 149-153 ◽  
Author(s):  
Susan E Krown ◽  
Jeannette Y Lee ◽  
Lan Lin ◽  
Margaret A Fischl ◽  
Richard Ambinder ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Protease Inhibitor ◽  
Kaposi Sarcoma

Kaposi Sarcoma of the Lower Extremity with HIV and Kaposi's Sarcoma

2021 ◽  
Vol 2 (1) ◽  
pp. 01-03
Author(s):  
Selma Bakar Dertlioğlu
Keyword(s):  
Antiretroviral Therapy ◽  
Oral Cavity ◽  
Lower Extremity ◽  
Respiratory System ◽  
Kaposi's Sarcoma ◽  
Kaposi Sarcoma ◽  
Kaposi’S Sarcoma ◽  
Newly Diagnosed ◽  
Clinical Variants ◽  
Common Malignancy

Kaposi's sarcoma is the most common malignancy seen with HIV infection. It is a lymphoangioproliferous tumor first described by Moritz Kaposi in 1872. It is characterized by bluish red or dark brown plaques and nodules, especially in the distal of the lower extremities, often the heels and feet. Organ involvement without skin findings is observed in approximately 15% of the cases. There are four clinical variants, the classical, endemic, iatrogenic and the epidemic associated with AIDS. Kaposi's sarcoma in AIDS cases apart from the skin, it can also be seen in the oral cavity, gastro-intestinal system and respiratory system. Antiretroviral therapy (ART) should be started immediately in newly diagnosed HIV infected patients. In this research, a 65 year old male patient, who was diagnosed AIDS and Kaposi's sarcoma at the same time, is described.

scholarly journals Retrospective analysis of HHV-8 viremia and cellular viral load in HIV-seropositive patients receiving interleukin 2 in combination with antiretroviral therapy

Blood ◽  
2002 ◽  
Vol 100 (5) ◽  
pp. 1575-1578 ◽  
Author(s):  
Mauro Malnati ◽  
Francesco Broccolo ◽  
Silvia Nozza ◽  
Loredana Sarmati ◽  
Silvia Ghezzi ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Interleukin 2 ◽  
Human Herpesvirus ◽  
Kaposi Sarcoma ◽  
Plasma Viremia ◽  
Herpesvirus 8 ◽  
Sequential Samples ◽  
Antibody Titers ◽  
Hiv Seropositive

The combination of interleukin 2 (IL-2) and antiretroviral therapy (ART) represents an emerging strategy in the treatment of patients infected with HIV. Aside from its immunomodulatory role, however, IL-2 may induce replication of human herpesvirus 8 (HHV-8)/Kaposi sarcoma (KS)–associated herpesvirus. We retrospectively evaluated HHV-8 plasma viremia and cellular load, as well as anti–HHV-8 antibody titers, in sequential samples from 84 patients receiving ART alone or in combination with IL-2. At baseline, HHV-8 plasma viremia was present only in 2 HHV-8–seropositive patients in whom KS subsequently developed during or immediately after termination of IL-2 therapy. The level of viremia increased during follow-up and peaked at the time of the clinical manifestation of KS. Moreover, transient peaks of HHV-8 viremia were temporally associated with administration of IL-2. HHV-8 plasma viremia was never detected in the other 47 patients receiving IL-2 nor in 35 controls treated only with ART. Thus, IL-2 therapy seems safe in most patients infected with both HIV and HHV-8, except for those with detectable HHV-8 viremia, who may not be eligible for IL-2 treatment.

scholarly journals Intractable pleural effusion in Kaposi sarcoma following antiretroviral therapy in a Caucasian female infected with HIV

2020 ◽  
Vol 13 (2) ◽  
pp. e233335 ◽  
Author(s):  
Pattraporn Tajarernmuang ◽  
Pierre-Olivier Fiset ◽  
Jean-Pierre Routy ◽  
Stéphane Beaudoin
Keyword(s):  
Antiretroviral Therapy ◽  
Immune Reconstitution ◽  
Kaposi Sarcoma ◽  
Caucasian Woman ◽  
Immune Reconstitution Syndrome ◽  
Pleural Effusions ◽  
Therapy Initiation ◽  
Caucasian Female ◽  
Pleural Involvement ◽  
Clinical Worsening

We report the case of a 57-year-old Caucasian woman with AIDS-related disseminated Kaposi sarcoma (KS) characterised by the combination of several unusual features. The chylous nature of the pleural effusions, the documented parietal pleural involvement at thoracoscopy and the marked clinical worsening through an immune reconstitution syndrome following antiretroviral therapy initiation represent several rare situations that occurred in the same female patient. In addition, the use of indwelling pleural catheters for dyspnoea palliation also represents a rare therapeutic intervention. This case is a reminder of the possibility of AIDS-related pleural KS, now uncommon in the era of antiretroviral therapy.

scholarly journals Incidence Rate of Kaposi Sarcoma in HIV-Infected Patients on Antiretroviral Therapy in Southern Africa

2014 ◽  
Vol 67 (5) ◽  
pp. 547-554 ◽  
Author(s):  
Eliane Rohner ◽  
Fabio Valeri ◽  
Mhairi Maskew ◽  
Hans Prozesky ◽  
Helena Rabie ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Incidence Rate ◽  
Southern Africa ◽  
Kaposi Sarcoma

scholarly journals Timing of Antiretroviral Therapy Initiation and Risk of Cancer Among Persons Living With Human Immunodeficiency Virus

2020 ◽  
Author(s):  
Michael J Silverberg ◽  
Wendy Leyden ◽  
Raúl U Hernández-Ramírez ◽  
Li Qin ◽  
Haiqun Lin ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Kaposi Sarcoma ◽  
Risk Difference ◽  
Right Censoring ◽  
Transmission Risk ◽  
Adjusted Risk ◽  
Art Initiation ◽  
Immunodeficiency Virus ◽  
Risk Of Cancer

Abstract Background Persons living with human immunodeficiency virus (HIV; PLWH) experience a high burden of cancer. It remains unknown which cancer types are reduced in PLWH with earlier initiation of antiretroviral therapy (ART). Methods We evaluated AIDS-free, ART-naive PLWH during 1996–2014 from 22 cohorts participating in the North American AIDS Cohort Collaboration on Research and Design. PLWH were followed from first observed CD4 of 350–500 cells/µL (baseline) until incident cancer, death, lost-to-follow-up, or December 2014. Outcomes included 6 cancer groups and 5 individual cancers that were confirmed by chart review or cancer registry linkage. We evaluated the effect of earlier (in the first 6 months after baseline) versus deferred ART initiation on cancer risk. Marginal structural models were used with inverse probability weighting to account for time-dependent confounding and informative right-censoring, with weights informed by subject’s age, sex, cohort, baseline year, race/ethnicity, HIV transmission risk, smoking, viral hepatitis, CD4, and AIDS diagnoses. Results Protective results for earlier ART were found for any cancer (adjusted hazard ratio [HR] 0.57; 95% confidence interval [CI], .37–.86), AIDS-defining cancers (HR 0.23; 95% CI, .11–.49), any virus-related cancer (HR 0.30; 95% CI, .16–.54), Kaposi sarcoma (HR 0.25; 95% CI, .10–.61), and non-Hodgkin lymphoma (HR 0.22; 95% CI, .06–.73). By 15 years, there was also an observed reduced risk with earlier ART for virus-related NADCs (0.6% vs 2.3%; adjusted risk difference −1.6; 95% CI, −2.8, −.5). Conclusions Earlier ART initiation has potential to reduce the burden of virus-related cancers in PLWH but not non-AIDS-defining cancers (NADCs) without known or suspected viral etiology.

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