TY - JOUR
T1 - AIDS-associated Kaposi's sarcoma is more aggressive in women
T2 - A study of 54 patients
AU - Nasti, Guglielmo
AU - Serraino, Diego
AU - Ridolfo, Annalisa
AU - Antinori, Andrea
AU - Rizzardini, Giuliano
AU - Zeroli, Claudia
AU - Nigro, Luciano
AU - Tavio, Marcello
AU - Vaccher, Emanuela
AU - Tirelli, Umberto
PY - 1999/4/1
Y1 - 1999/4/1
N2 - 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.
AB - 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.
KW - HIV infection
KW - Kaposi's sarcoma
KW - Women
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M3 - Article
C2 - 10096577
AN - SCOPUS:0033001986
VL - 20
SP - 337
EP - 341
JO - Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology
JF - Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology
SN - 1077-9450
IS - 4
ER -