Kaposi's sarcoma and non-Hodgkin's lymphomas in children and adolescents with AIDS.

OBJECTIVE

To assess the proportion of, and the characteristics associated with, Kaposi's sarcoma (KS) and non-Hodgkin's lymphomas (NHL) in children (0-12 years) and adolescents (13-19 years) at AIDS diagnosis, in Europe and in the United States (US).

DESIGN

Comparison of the proportions of KS and NHL at AIDS diagnosis, according to various characteristics, by means of the European Non-Aggregate AIDS Data Set (4400 children and 764 adolescents) and the US AIDS Public Information Data Set (4710 children and 1064 adolescents) updated to June 1993.

METHODS

Comparison of data was made using odds ratios (OR) and corresponding 95% confidence intervals.

RESULTS

Between 0 and 19 years, the proportion of KS at AIDS diagnosis (0.5% in Europe and 0.9% in the US) increased with age, particularly in Europe, and was higher in males than in females. It decreased with time in the US but not in Europe. In the US, black children showed a nearly threefold excess of KS as compared with white children. Adolescents who reported homosexual intercourse with other males had significantly elevated risks of KS, both in Europe (OR, 6.3) and in the US (OR, 21.1). NHL was diagnosed in 0.9% of children in Europe and in 1.5% in the US. The proportion of NHL significantly increased with age (3.1% among adolescents in Europe and 3.0% in the US), and was higher in males than in females. In the US, NHL tended to decline in proportion with all AIDS cases over time and showed a nearly twofold higher frequency in white children. No association emerged between NHL and HIV transmission category.

CONCLUSIONS

In agreement with incidence rates in the general paediatric population, but at variance with AIDS in adults, NHL turned out to be more common than KS in children and adolescents with AIDS. A strong excess of KS was already present in adolescents who reported homosexual intercourse.