Document 0522
 DOCN  M9460522
 TI    Risk factors for Kaposi's sarcoma in patients with advanced human
       immunodeficiency virus disease treated with zidovudine. Zidovudine
       Epidemiology Study Group.
 DT    9404
 AU    Gallant JE; Moore RD; Richman DD; Keruly J; Chaisson RE; Department of
       Medicine, Johns Hopkins University School of; Medicine, Baltimore, Md.
 SO    Arch Intern Med. 1994 Mar 14;154(5):566-72. Unique Identifier : AIDSLINE
       MED/94168504
 AB    BACKGROUND: Although the cause of Kaposi's sarcoma (KS) is unknown, its
       unique epidemiology suggests that an infectious, sexually transmitted
       agent or agents may contribute to its pathogenesis. METHODS: To assess
       the natural history of KS associated with the acquired immunodeficiency
       syndrome and to identify factors associated with its development, data
       were analyzed from a multicenter, observational cohort study of 1044
       persons with the acquired immunodeficiency syndrome or the acquired
       immunodeficiency syndrome-related complex and a total CD4 cell count of
       less than 0.25 x 10(9)/L who were treated with zidovudine between April
       1987 and April 1988. Records were reviewed bi-monthly. Follow-up
       continued for 2 years or until death. RESULTS: One hundred thirty-one
       patients (13%) had KS a study enrollment, and 143 developed KS (14%)
       during follow-up, with a 2-year actuarial risk of 21%. The probability
       of KS at 2 years for patients with initial CD4 cell counts of less than
       0.1 x 10(9)/L was 25%, compared with 15% for those with counts of 0.1 x
       10(9)/L or more. By logistic regression, a baseline CD4 cell count of
       less than 0.1 x 10(9)/L (relative odds, 1.43; 95% confidence interval,
       1.04 to 1.95), homosexuality (relative odds, 3.71; 95% confidence
       interval, 1.82 to 7.56), cytomegalovirus disease (relative odds, 1.56;
       95% confidence interval, 1.01 to 2.41), and white race (relative odds,
       1.64; 95% confidence interval, 1.11 to 2.43) were independently
       associated with KS. Median survival after KS was 408 days, and KS was an
       independent predictor of death (relative hazard, 1.78; 95% confidence
       interval, 1.26 to 2.52). CONCLUSIONS: Kaposi's sarcoma contributes to
       human immunodeficiency virus-related morbidity and mortality, especially
       among male homosexuals. This large cohort study provides further
       evidence for an association between risk for cytomegalovirus infection
       and KS.
 DE    Acquired Immunodeficiency Syndrome/COMPLICATIONS  AIDS-Related
       Complex/COMPLICATIONS  Female  Human  HIV Infections/*COMPLICATIONS/DRUG
       THERAPY  Logistic Models  Male  Proportional Hazards Models  Prospective
       Studies  Risk Factors  Sarcoma, Kaposi's/*ETIOLOGY  Support, Non-U.S.
       Gov't  Zidovudine/*THERAPEUTIC USE  JOURNAL ARTICLE  MULTICENTER STUDY

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).