Document 0380
 DOCN  M9590380
 TI    Prognosis of Kaposi's sarcoma as a primary and secondary AIDS defining
       illness.
 DT    9509
 AU    Padiglione A; Goldstein D; Law M; Kaldor J; Hoy J; Mijch A; Fairfield
       Hospital.
 SO    Annu Conf Australas Soc HIV Med. 1994 Nov 3-6;6:109 (unnumbered
       abstract). Unique Identifier : AIDSLINE ASHM6/95291719
 AB    The natural history of Kaposis sarcoma (KS) as a primary presentation
       has been well defined but there is little known about prognosis
       following KS in subjects with a different primary AIDS defining illness
       (ADI). We analysed a consecutive series of 213 HIV positive individuals
       diagnosed with KS at Fairfield Hospital between 1984 and 1994. We found
       no difference over time in KS survival. Median survival for KS ADI (N =
       129) was 19.5 months versus 8 months for KS subsequent to another ADI (N
       = 84) p < 0.001. Those with KS ADI had a higher CD4 count (mean 165 vs
       34, P < 0.001) and lower incidence of visceral disease (4/129 vs 14/84,
       p = 0.002). A Cox model showed poorer survival following diagnosis of KS
       was associated with a lower CD4 count at diagnosis of KS (p = 0.002),
       extensive cutaneous or visceral KS at diagnosis (p = 0.009 and p < 0.001
       respectively) and also with development of KS subsequent to an ADI (p <
       0.001). In the 84 patients with KS subsequent to an ADI, only the extent
       of KS at diagnosis was significantly associated with survival (p <
       0.001). Duration of AIDS to KS, CD4 count at AIDS and CD4 count at KS
       were not significantly associated with survival in this group (p >
       0.65). This study suggests that KS as a secondary ADI carries a much
       poorer prognosis than as an ADI even after adjustment for CD4 count at
       KS and extent of KS. We cannot exclude however that this is due to
       reporting bias. Our findings may suggest the biology of KS as a
       subsequent illness is more aggressive than as a primary diagnosis and
       may influence choice of therapy.
 DE    Acquired Immunodeficiency Syndrome/*DIAGNOSIS/IMMUNOLOGY/  MORTALITY
       CD4 Lymphocyte Count  Human  Prognosis  Sarcoma,
       Kaposi's/*DIAGNOSIS/IMMUNOLOGY/MORTALITY  Survival Rate  MEETING
       ABSTRACT

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