Klingenberg R-E, Esser S, Brockmeyer N H, Michalik C, Skaletz-Rorowski A, Potthoff A
Interdisziplinäre Immunologische Ambulanz, Zentrum für Sexuelle Gesundheit und Medizin, WIR - Walk In Ruhr, Klinik für Dermatologie, Venerologie und Allergologie, Ruhr-Universität Bochum, Große Beck Str. 12, 44787, Bochum, Deutschland.
Klinik für Dermatologie, Universitätsklinikum Essen, Essen, Deutschland.
Hautarzt. 2018 Feb;69(2):143-148. doi: 10.1007/s00105-017-4062-9.
Kaposi's sarcoma (KS) represents the most common AIDS-defining neoplasm. Only very few studies regarding the course and treatment of human immunodeficiency virus (HIV)-associated KS have been carried out in Germany.
In this study the course of HIV-associated KS was observed in patients from the cohort database of the competence network for HIV/AIDS.
Data from HIV-associated KS patients from 9 German core centers from 1987 to 2011 were retrospectively collected. Kaplan-Meier curves for the recurrence and survival probability were calculated.
In 222 patients KS was diagnosed at a median age of 38.5 ± 10.1 years. Men were almost exclusively affected (97.7%). The HIV viral load at the time of diagnosis was in 7.4% <50 copies/ml. Of the patients 55.5% developed KS with a CD4 cell count of <200 cells/μl and 9.5% with >500 cells/μl. In 68 patients KS therapy consisted exclusively of the optimization or initiation of antiretroviral therapy (ART). In addition, 71 patients were treated with pegylated liposomal doxorubicin. During the median follow-up period of 8.9 ± 4.9 years, 80.2% of the patients were free of KS recurrence. Survival rates after 5 and 10 years were 96.8% and 91.3%, respectively.
Even with a good immune status HIV-associated KS occurred. An effective ART was the most important mainstay of therapy. With appropriate therapy, HIV-positive patients with KS showed a good survival rate.
卡波西肉瘤(KS)是最常见的艾滋病定义性肿瘤。在德国,关于人类免疫缺陷病毒(HIV)相关KS的病程及治疗的研究极少。
本研究在HIV/AIDS能力网络队列数据库的患者中观察HIV相关KS的病程。
回顾性收集了1987年至2011年德国9个核心中心HIV相关KS患者的数据。计算复发和生存概率的Kaplan-Meier曲线。
222例患者被诊断为KS,中位年龄为38.5±10.1岁。几乎仅男性受累(97.7%)。诊断时HIV病毒载量<50拷贝/ml的患者占7.4%。55.5%的患者在CD4细胞计数<200个/μl时发生KS,9.5%的患者在CD4细胞计数>500个/μl时发生KS。68例患者的KS治疗仅包括抗逆转录病毒治疗(ART)的优化或启动。此外,71例患者接受了聚乙二醇化脂质体阿霉素治疗。在中位随访期8.9±4.9年期间,80.2%的患者无KS复发。5年和10年生存率分别为96.8%和91.3%。
即使免疫状态良好,仍会发生HIV相关KS。有效的ART是最重要的治疗支柱。通过适当治疗,HIV阳性KS患者生存率良好。