Risk factors for mortality in AIDS-associated Kaposi sarcoma in a primary care antiretroviral treatment program in Malawi

Chu, Kathryn; Misinde, Dalitso; Massaquoi, Moses; Pasulani, Olesi; Mwagomba, Beatrice; Ford, Nathan; Zachariah, Rony

doi:10.1016/j.inhe.2010.04.001

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Volume 2, Issue 2 , Pages 99-102, June 2010

Risk factors for mortality in AIDS-associated Kaposi sarcoma in a primary care antiretroviral treatment program in Malawi

Kathryn Chu
- Médecins Sans Frontières, 49 Jorissen St, Braamfontein 2017, Johannesburg, South Africa
- Department of International Health, Johns Hopkins M, Baltimore, MD, USA
- Corresponding author at: Unit 23B, No 14, Waverly Business Park, Wyecroft Road, Mowbray 7700, Cape Town, South Africa. Tel.: +27 79 895 2489; fax: +27 21 448 3128.
Dalitso Misinde
- Médecins Sans Frontières, Thyolo, Malawi
Moses Massaquoi
- Médecins Sans Frontières, Thyolo, Malawi
Olesi Pasulani
- Médecins Sans Frontières, Thyolo, Malawi
Beatrice Mwagomba
- Ministry of Health, Thyolo, Malawi
Nathan Ford
- Médecins Sans Frontières, 49 Jorissen St, Braamfontein 2017, Johannesburg, South Africa
Rony Zachariah
- Médecins Sans Frontières, Medical Department, (Operational Research Unit), Brussels, Belgium

Received 19 November 2009; received in revised form 25 February 2010; accepted 7 April 2010.

Summary

AIDS-associated Kaposi sarcoma (AIDS-KS) is the most common HIV-related malignancy. The majority of cases are found in sub-Saharan Africa. This retrospective cohort study describes characteristics of patients with AIDS-KS and factors associated with mortality in an antiretroviral treatment (ART) program in rural Malawi. Of 11 122 patients enrolled on ART, 830 (7%) had AIDS-KS. Patients with AIDS-KS were more likely to be lost to follow-up (22% versus 14%, P<0.001) and showed a higher mortality (22% versus 10%, P<0.001) compared to patients without AIDS-KS. A CD4 count ≤150 cells/μl, advanced stage AIDS-KS, and absence of bleomycin chemotherapy were associated with increased mortality. Earlier diagnosis and improved treatment of AIDS-KS are urgently needed in order to reduce mortality.