Mortality disparities among patients with HIV-associated kaposi's sarcoma in the southern united states

AIDS. 2021 Dec 22. doi: 10.1097/QAD.0000000000003155. Online ahead of print.


OBJECTIVE: To describe risk factors for mortality in HIV-associated Kaposi’s sarcoma (KS) in an urban population in Dallas, Texas.

DESIGN: Retrospective electronic medical record review of patients with HIV-associated Kaposi’s sarcoma.

METHODS: Electronic medical records were reviewed from 1/1/2009 to 12/31/2018 for patients with a diagnosis of HIV and KS by ICD-9 or -10 codes. Demographics, HIV history, KS history, treatment and mortality data were collected. Mortality data was supplemented by an inquiry from the National Death Index. Survival analyses were performed using Cox proportional hazards analysis to determine independent predictors of mortality.

RESULTS: Black patients had higher mortality than White or Hispanic patients (HR 2.07, 95% confidence interval 1.12 – 3.82), even after adjusting for covariates. This mortality difference correlates with higher rates of advanced KS disease and KS-IRIS in Black patients compared to other groups and is not explained by differences in CD4 count, HIV viral load, engagement in care or ART adherence at the time of cancer diagnosis.

CONCLUSION: Despite nationwide trends showing decreased incidence and decreased mortality in Kaposi’s sarcoma in the ART era, a high number of KS cases and disparities in KS outcomes persist in certain populations in the United States.

PMID:34930860 | DOI:10.1097/QAD.0000000000003155