Ebrahim S H, Peterman T A, Zaidi A A, Hamers F F
Centers for Disease Control and Prevention, Atlanta 30333, USA.
AIDS. 1997 Nov 15;11(14):1739-45. doi: 10.1097/00002030-199714000-00011.
Classical Kaposi's sarcoma (KS) is about four times more common in southern Europeans than in northern Europeans.
To describe the epidemiology of AIDS-associated KS (AIDS-KS) in Europe and to determine whether it occurs with increased frequency in southern Europe.
Analysis of the 'European non-aggregate AIDS data set', as of September 1995. Countries with a cumulative total of > or = 50 KS cases as the presenting manifestation of AIDS were included. Homosexual men were excluded from south versus non-south comparisons because of possible confounding effects due to their route of HIV transmission.
KS was the presenting manifestation of AIDS for 13.3% (16,367 out of 122,679) of men and 2% (491 out of 24,826) of women. In all countries, the risk for KS was higher in individuals who acquired HIV infection via sexual rather than parenteral transmission. Among AIDS patients, there is little difference by sex in the risk of KS in injecting drug users (IDU) or transfusion recipients. The percentage with KS increased with age among homosexual and bisexual men, from 10% in the age group 15-19 years to 23% in the age group 30-39 years. In all countries, the percentage with KS declined over time. The risk of KS was not significantly higher in southern Europe. The percentage with KS in southern Europe was slightly lower than in northern Europe (P > 0.1) in male IDU (1.8% versus 2.1%), and only slightly higher (P > 0.1) in female IDU (1.5% versus 1.1%), in male transfusion recipients (3.5% versus 3.0%), in female transfusion recipients (2.4% versus 2.3%), and in both heterosexual men (7.5% versus 6.2%) and women (2.0% versus 1.6%) excluding those originating from countries where heterosexual HIV transmission is frequent.
The strong geographic predilection described for classical KS in southern Europe was not seen for AIDS-KS. If KS is caused by a viral infection in an immunodeficient host, our findings suggest the geographical variations in classical KS are not due to variation in prevalence of the causative virus but may be due to geographical variations in the prevalence of a form of mild immunodeficiency.
经典型卡波西肉瘤（KS）在南欧的发病率比北欧高约四倍。
描述欧洲艾滋病相关卡波西肉瘤（AIDS-KS）的流行病学特征，并确定其在南欧的发病率是否更高。
分析截至1995年9月的“欧洲非汇总艾滋病数据集”。纳入艾滋病首发表现为KS且累计病例数≥50例的国家。在比较南欧与非南欧地区时，排除男同性恋者，因为其HIV传播途径可能产生混杂效应。
KS是13.3%（122,679名男性中的16,367例）男性和2%（24,826名女性中的491例）女性艾滋病的首发表现。在所有国家，通过性传播而非非肠道传播感染HIV的个体患KS的风险更高。在艾滋病患者中，注射吸毒者（IDU）或输血接受者患KS的风险在性别上差异不大。男同性恋和双性恋男性中患KS的比例随年龄增加，从15-19岁年龄组的10%增至30-39岁年龄组的23%。在所有国家，患KS的比例随时间下降。南欧患KS的风险没有显著更高。在男性IDU中，南欧患KS的比例略低于北欧（1.8%对2.1%，P>0.1），在女性IDU中略高（1.5%对1.1%，P>0.1），在男性输血接受者中略高（3.5%对3.0%），在女性输血接受者中略高（2.4%对2.3%），在异性恋男性（7.5%对6.2%）和女性（2.0%对1.6%）中也是如此，排除来自异性传播HIV频繁国家的人群。
南欧经典型KS所描述的强烈地理偏好性在AIDS-KS中未观察到。如果KS是由免疫缺陷宿主中的病毒感染引起的，我们的研究结果表明，经典型KS的地理差异不是由于致病病毒流行率的差异，而是可能由于一种轻度免疫缺陷形式的流行率的地理差异。
