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Burden, characteristics, management and outcomes of HIV-infected patients with Kaposi's sarcoma in Zomba, Malawi | Journal Article / Research | MSF Science Portal
Journal Article
|Research

Burden, characteristics, management and outcomes of HIV-infected patients with Kaposi's sarcoma in Zomba, Malawi

Mwinjiwa E, Isaakidis P, Van Den Berg R, Harries AD, Bezanson KD, Beyene T, Thompson C, Joshua M, Akello H, van Lettow M
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Abstract
SETTING
Antiretroviral treatment (ART) clinic at Zomba Central Hospital, Malawi.

DESIGN
Retrospective analysis of records (2004-2011) of human immunodeficiency virus (HIV) infected patients with Kaposi's sarcoma (KS).

OBJECTIVES
To determine the number and characteristics of HIV-infected adult patients with KS on ART and vincristine (VCR) therapy and their treatment outcomes.

RESULTS
A total of 545 HIV-infected patients with KS (58% male, median age 33 years) were included in the study. The baseline median CD4 count was 180 cells/µl (interquartile range 111-287). Cumulative outcomes were as follows: 168 (31%) were still alive, 133 (24%) had died, 172 (32%) were lost to follow-up and 71 (13%) had transferred out; 229 had received at least one course of VCR, 171 had received less than one full course and 145 had not received VCR. The survival probability for 229 patients who received at least one course of VCR was 65% at 1 year, 42% at 2 years and 13% by 6 years. Patients who started VCR therapy before or concurrently with ART had a higher risk of death and generally a higher risk of death and loss to follow-up than those who started VCR after ART.

CONCLUSION
Poor outcomes were noted in HIV-infected patients with KS in a programme setting in Malawi. Other treatment interventions, including combination and/or second-line chemotherapy and earlier ART initiation, are needed to reduce morbidity and mortality.

Countries

Malawi

Subject Area

SORT-IT

Languages

English
DOI
10.5588/pha.13.0003
Published Date
21 Jun 2013
PubMed ID
26393024
Journal
Public Health Action
Volume | Issue | Pages
Volume 3, Issue 2
Issue Date
2013-06-21
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