AIDS-associated Kaposi's sarcoma is more aggressive in women: A study of 54 patients

Guglielmo Nasti, Diego Serraino, Annalisa Ridolfo, Andrea Antinori, Giuliano Rizzardini, Claudia Zeroli, Luciano Nigro, Marcello Tavio, Emanuela Vaccher, Umberto Tirelli

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Abstract

Objective: To describe the epidemiologic and clinical features of AIDS- associated Kaposi's sarcoma (KS) in women compared with men. Methods: In a retrospective study, within the Italian Cooperative Group on AIDS and Tumors (GICAT), we compared selected characteristics of 54 women and 108 men with AIDS-associated KS, matched by date of KS diagnosis and referral hospital. The χ2 test was used to test differences among proportions; the Kaplan- Meier method to estimate the survival time, and the Cox proportional hazard model was used to assess the role of gender, age, and CD4 cell count on death's risk. Results: KS occurred at an earlier age (p = .001), was associated with a more severe immunodeficiency (p = .03), more advanced stages of HIV disease (p = .05), and had more aggressive presentation and course in women than in men. At KS diagnosis, women had a significantly increased proportion of visceral disease (p = .009), in particular pulmonary involvement (p = .002) and atypical sites of involvement (p = .008). The number of deaths due to KS was significantly higher (p = .01) in female patients. Both the higher proportion of visceral disease and of KS-related deaths observed in women did not change after adjusting for CD4 cell count and age. Women showed a decreased overall survival compared with men (8.9 and 14.4 months, respectively; p = .07), and the CD4 cell count at diagnosis significantly influenced survival. Conclusions: This study suggests that KS is more aggressive and life threatening in female than in male patients. This peculiar clinical behavior may reflect an inherently more aggressive biology of KS in women, possibly mediated by the level of immunodeficiency.

Original languageEnglish
Pages (from-to)337-341
Number of pages5
JournalJournal of Acquired Immune Deficiency Syndromes and Human Retrovirology
Volume20
Issue number4
Publication statusPublished - Apr 1 1999

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Keywords

  • HIV infection
  • Kaposi's sarcoma
  • Women

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Virology

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