CROI 2016 Abstract eBook

Abstract Listing

Poster Abstracts

631 Kaposi Sarcoma Survival in Adults: The South African Antiretroviral Treatment Era Mazvita M. Sengayi 1 ; Danuta M. Kielkowski 1 ; Matthias Egger 2 ; Lydia Dreosti 3 ; Julia Bohlius 4 1 Natl Cancer Registry, NHLS, Johannesburg, South Africa; 2 Univ Hosp Bern, Bern, Switzerland; 3 Univ of Pretoria and Steve Biko Academic Hosp, Pretoria, South Africa; 4 Inst of Social and Preventive Med, Univ of Bern, Bern, Switzerland

Background: Kaposi sarcoma (KS) is the most common malignancy in HIV infected people in sub-Saharan Africa. The advent of antiretroviral treatment (ART) in western countries resulted in dramatic decreases in KS incidence, morbidity and mortality. Studies in the early ART era in South Africa have shown that KS morbidity and mortality is still high due to inadequate antiretroviral treatment coverage and late diagnosis. The South African ART national programme is well established with over a decade of rapid scale-up of ART programmes nationwide. We examined whether the wider availability of ART improved survival of KS patients receiving care from a tertiary academic hospital oncology unit in Pretoria, South Africa. Methods: We did a retrospective review of electronic and paper records of HIV-positive KS patients accessing treatment at the Steve Biko Academic Hospital (SBAH) oncology unit between May 2004 and September 2012. We compared survival of KS patients admitted 2004-2008 and 2009-2012 and examined predictors of mortality. Patient characteristics were described using frequencies, medians and interquartile ranges. Kaplan Meier survival functions were used to estimate survival at one and two years of follow-up and multivariable Cox regression models were fitted to identify predictors for mortality.

Poster Abstracts

Results: A total of 357 HIV-positive KS patients were included in the analysis. Nearly all patients (353, 99%) were Black Africans, (224, 63%) were male, the median age at cancer diagnosis was 37 (IQR 30-43 years) and median CD4 count was 242 (130-403 cells/µL). Most patients received ART (332, 93%), 101 (28%) received chemotherapy and radiotherapy, 108 (30%) received radiotherapy only, 68 (19%) received chemotherapy only, and 80 (22%) did not receive radio- or chemotherapy. One-year survival was 75% (95% CI 66-82) and 85% (95% CI 78-90) in the 2004-2008 and 2009-2012 time-periods, respectively (p<0.001). Two-year survival was 60% (95% CI 50-69) and 83% (95% CI 73-88) in the 2004-2008 and 2009-2012 time-periods, respectively (p<0.001). More recent calendar period, chemotherapy, radiotherapy and less advanced disease stage were associated with improved survival (Table). Conclusions: The survival of HIV-positive patients with KS has improved in recent years in South Africa as more patients access ART. Chemotherapy and radiation therapy improves survival of HIV-positive patients with KS.

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CROI 2016