Jones J L, Hanson D L, Dworkin M S, Jaffe H W
Division of HIV/AIDS Prevention Surveillance and Epidemiology, National Center for HIV, STD, and TB Prevention, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30341-3724, USA.
J Acquir Immune Defic Syndr. 2000 Jul 1;24(3):270-4. doi: 10.1097/00126334-200007010-00013.
To evaluate the impact of antiretroviral and antiherpesvirus therapies on the incidence of KS and assess trends in incidence of Kaposi's sarcoma (KS) in a large multicenter HIV/AIDS surveillance system between 1990 and 1998.
Incidence was calculated per 100 person-years (py); the effects of therapies on risk for KS were calculated by using multivariate Poisson regression controlling for gender, race/ethnicity, age, HIV exposure mode, CD4+ cell count, and calendar year. Antiretroviral therapy was defined as monotherapy, dual therapy, or triple therapy (95% of triple therapy regimens contained a protease inhibitor). Acyclovir, ganciclovir, and foscarnet were the antiherpesvirus therapies evaluated.
There were 37,303 HIV-infected people in the study contributing 70,238 py. Those prescribed triple antiretroviral therapy had a 50% reduction in the incidence of KS (95% confidence interval, 20%-70%) compared with those who were not prescribed antiretroviral therapy and there was a reduction in risk for KS among persons prescribed foscarnet (p =.05). Overall, KS incidence declined an estimated 8.8% per year (observed incidence 4. 1 per 100 py in 1990 to 0.7 per 100 py in 1998; p <.001).
Incidence of KS is declining in this large U.S. population and may continue to decline as new, more effective antiretroviral agents are developed and used widely.
评估抗逆转录病毒疗法和抗疱疹病毒疗法对卡波西肉瘤（KS）发病率的影响，并评估1990年至1998年间一个大型多中心HIV/AIDS监测系统中卡波西肉瘤（KS）发病率的变化趋势。
发病率按每100人年（py）计算；通过多变量泊松回归分析计算疗法对KS发病风险的影响，该分析控制了性别、种族/民族、年龄、HIV暴露方式、CD4 +细胞计数和日历年等因素。抗逆转录病毒疗法定义为单药治疗、双药治疗或三药治疗（95%的三药治疗方案包含一种蛋白酶抑制剂）。阿昔洛韦、更昔洛韦和膦甲酸钠是所评估的抗疱疹病毒疗法。
研究中有37303名HIV感染者，贡献了70238人年。与未接受抗逆转录病毒疗法的人相比，接受三联抗逆转录病毒疗法的人KS发病率降低了50%（95%置信区间，20% - 70%），接受膦甲酸钠治疗的人KS发病风险降低（p = 0.05）。总体而言，KS发病率估计每年下降8.8%（1990年观察到的发病率为每100人年4.1例，到1998年为每100人年0.7例；p < 0.001）。
在美国这个庞大的人群中，KS发病率正在下降，并且随着新的、更有效的抗逆转录病毒药物的开发和广泛使用，可能会继续下降。
