Analyses of Kaposi Sarcoma trends among adults establishing initial outpatient HIV care in Nigeria: 2006-2017.

Autor: Akanbi MO; Department of Internal Medicine, McLaren Hospital, 401 S Ballenger Hwy, Flint, MI, 48532, USA. Maxwell.akanbi@mclaren.org.; Health Sciences Integrated Ph.D. Program, Center for Education in Health Sciences, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA. Maxwell.akanbi@mclaren.org.; Robert J Havey Institute for Global Health, Center for Global Communicable Diseases, Feinberg School of Medicine, Northwestern University, Chicago, USA. Maxwell.akanbi@mclaren.org.; Department of Medicine, College of Health Sciences, University of Jos, Jos, Nigeria. Maxwell.akanbi@mclaren.org., Bilaver LA; Health Sciences Integrated Ph.D. Program, Center for Education in Health Sciences, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA., Achenbach C; Robert J Havey Institute for Global Health, Center for Global Communicable Diseases, Feinberg School of Medicine, Northwestern University, Chicago, USA.; Department of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, USA., Hirschhorn LR; Robert J Havey Institute for Global Health, Center for Global Communicable Diseases, Feinberg School of Medicine, Northwestern University, Chicago, USA.; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, USA., Rivera AS; Health Sciences Integrated Ph.D. Program, Center for Education in Health Sciences, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA., Silas OA; Department of Pathology, College of Human Sciences, University of Jos, Jos, Nigeria., Agaba PA; Department of Family Medicine, College of Human Sciences, University of Jos, Jos, Nigeria., Agbaji O; Department of Medicine, College of Health Sciences, University of Jos, Jos, Nigeria., Shehu NY; Department of Medicine, College of Health Sciences, University of Jos, Jos, Nigeria., Sagay SA; Department of Obstetrics and Gynecology, College of Human Sciences, University of Jos, Jos, Nigeria., Hou L; Health Sciences Integrated Ph.D. Program, Center for Education in Health Sciences, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA.; Department of Prevention Diseases (Cancer Epidemiology and Prevention), Northwestern University Feinberg School of Medicine, Chicago, USA.; Institute for Global Health, Center for Global Oncology, Feinberg School of Medicine, Northwestern University, Chicago, USA., Murphy RL; Robert J Havey Institute for Global Health, Center for Global Communicable Diseases, Feinberg School of Medicine, Northwestern University, Chicago, USA.; Department of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, USA.
Jazyk: angličtina
Zdroj: Infectious agents and cancer [Infect Agent Cancer] 2022 Mar 21; Vol. 17 (1), pp. 10. Date of Electronic Publication: 2022 Mar 21.
DOI: 10.1186/s13027-022-00424-4
Abstrakt: Background: The incidence of Human Immunodeficiency Virus (HIV)-associated Kaposi Sarcoma (KS) in the pre-antiretroviral therapy (ART) population remains high in several countries in sub-Saharan Africa. We examined trends of KS prevalence in adults, establishing initial outpatient HIV care from 2006 to 2017 in Nigeria.
Methods: We analyzed data of 16,431 adults (age ≥ 18 years) enrolled for HIV care from January 1, 2006, to December 31, 2017, in a large clinic in Jos, Nigeria. KS at enrollment was defined as KS recorded in the electronic health record within 30 days of clinic enrollment. Time trends were compared among four periods: 2006-2008, 2009-2011, 2012-2014, and 2015-2017 using logistic regression models. Annual trends were analyzed using join point regression and restricted splines.
Results: The study population had a mean age 35.1 (standard deviation, SD 9.5) years, and were 65.7% female (n = 10,788). The mean CD4 cell count was 220 (95% CI 117-223). The overall KS prevalence at entry was 0.59% (95% CI 0.48-0.72). Compared to 2006-2008, KS prevalence was significantly higher in 2009-2011 (adjusted odds ratio 5.07 (95% CI 3.12-8.24), p < 0.001), but remained unchanged in subsequent periods. Male sex and low CD4 T-cell count independently increased odds for KS.
Conclusions: Despite ART expansion, KS at enrollment showed no significant decline. The low CD4 cell count, across all periods, indicates delay in enrollment for HIV care, which increases KS risk. Interventions aimed at early HIV diagnosis and linkage to ART is critical to KS risk reduction in this population.
(© 2022. The Author(s).)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje