Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.
Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, Shanghai, China.
HIV Med. 2018 May;19(5):355-364. doi: 10.1111/hiv.12584. Epub 2018 Jan 25.
Kaposi's sarcoma (KS) is a multicentric angioproliferative cancer of endothelial origin typically occurring in the context of immunosuppression or immunodeficiency. Consequently, KS is one of the most common cancers in HIV-infected individuals and frequently occurs among transplant recipients. Nevertheless, its incidence in different populations is not well understood.
We searched online databases for publications on KS incidence. A random-effect meta-analysis was performed to combine the KS incidences and incidence rate ratios (IRRs) for associated risk factors.
Seventy-six eligible studies representing 71 time periods were included. For HIV-infected people, the overall KS incidence was 481.54 per 100 000 person-years with a 95% confidential interval (CI) of 342.36-677.32 per 100 000 person-years. HIV-infected men who have sex with men (MSM) had the highest incidence of KS (1397.11 per 100 000 person-years; 95% CI 870.55-2242.18 per 100 000 person-years). The incidence of KS was significantly lower in female than in male individuals (IRR 3.09; 95% CI 1.70-5.62). People receiving highly active antiretroviral therapy (HAART) had a lower incidence compared with people who had never received HAART (IRR 6.57; 95% CI 1.91-24.69). The incidence of KS was 68.59 (95% CI 31.39-149.86) per 100 000 person-years in transplant recipients, 52.94 (95% CI 39.90-70.20) per 100 000 person-years in children with HIV infection, and 1.53 (95% CI 0.33-7.08) per 100 000 person-years in the general population.
Globally, a relatively high incidence of KS was found among HIV-seropositive people and, in particular, in HIV-infected MSM. The introduction of HAART has largely prevented the development of KS, but it has not entirely removed the challenge of KS. In Africa, in particular, KS imposes a very heavy disease burden, which can mainly be attributed to the high prevalence of KS-associated herpesvirus and poor access to HAART.
卡波西肉瘤（KS）是一种多中心的血管增生性内皮起源的癌症，通常发生在免疫抑制或免疫缺陷的情况下。因此，KS 是 HIV 感染者中最常见的癌症之一，并且经常发生在移植受者中。然而，其在不同人群中的发病率尚不清楚。
我们在线数据库中搜索有关 KS 发病率的出版物。进行随机效应荟萃分析，以合并相关危险因素的 KS 发病率和发病率比（IRR）。
有 76 项符合条件的研究代表 71 个时间段，被纳入分析。对于 HIV 感染者，KS 的总体发病率为每 100000 人年 481.54 例，95%可信区间（CI）为每 100000 人年 342.36-677.32 例。男男性行为者（MSM）HIV 感染者的 KS 发病率最高（每 100000 人年 1397.11 例；95%CI 870.55-2242.18 例）。女性 KS 的发病率明显低于男性（IRR 3.09；95%CI 1.70-5.62）。与从未接受过高效抗逆转录病毒治疗（HAART）的人相比，接受 HAART 的人的发病率较低（IRR 6.57；95%CI 1.91-24.69）。移植受者的 KS 发病率为每 100000 人年 68.59（95%CI 31.39-149.86），HIV 感染儿童为每 100000 人年 52.94（95%CI 39.90-70.20），普通人群为每 100000 人年 1.53（95%CI 0.33-7.08）。
在全球范围内，HIV 血清阳性人群，特别是 HIV 感染的 MSM，KS 的发病率相对较高。HAART 的引入在很大程度上阻止了 KS 的发展，但并未完全消除 KS 带来的挑战。特别是在非洲，KS 带来了非常沉重的疾病负担，这主要归因于 KS 相关疱疹病毒的高流行率和获得 HAART 的机会有限。
