Program Schedule

1158
Significance of HIV Viral Load and CD4 Count on Kaposi Sarcoma in the Era of Highly-Active-Antiretroviral Therapy

Session: Poster Abstract Session: Viral Infections: Pathogenesis
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • hivposter_final.pdf (386.7 kB)
  • Background: Approximately 20% of patients with HIV will have Kaposi Sarcoma (KS) and about half will die within 3 months of diagnosis. Incidence and outcomes of KS have traditionally been linked to CD4 counts <350. More recently, KS has been increasingly described in higher CD4 counts and variable presentations in the era of Highly-Active-Antiretroviral-Therapy (HAART). No studies have established the role of Viral Load (VL) on KS. Goal : To determine the effect of CD4 count and HIV VL on KS presentation and outcomes.

    Methods: Retrospective review of KS patients with HIV admitted over 12 years (2000-2012). KS patients without HIV infection were excluded. Patients were divided into 4 groups based on CD4 count (>200 or < 200) and VL (>100,000 or <100,000). Groups were analyzed with regards to KS severity (good vs poor risk), extent (soft-tissue vs visceral), receipt of HAART and survival (<3 months vs >6 months). Statistical analysis was done via Chi-Square.

    Results: 43 patients were included. KS affected predominantly young (30-40yrs), male (93%) HIV patients with VL >100,000 (85%) and CD4 counts <200 (53.4%). Patients with VL >100,000 had a statistically significant increased incidence of visceral involvement (96%, p<0.001) and more severe disease (71.9% poor risk). No statistically significant difference between receipt of HARRT and survival was seen between patients with viral load >100,000 and < 100,000. Patients with CD4 counts <200, showed a trend towards less severe disease (66.7% with good risk), increased survival (59.4% survived > 6 months) and less use of HAART (20%). Although, these differences were statistically insignificant.

    Conclusion: HIV VL of >100,000 is correlated with increased severity and extent of KS. Though statistically insignificant, CD4 counts <200 showed a trend for less severe disease and increased survival despite less use of HAART. Larger prospective studies are warranted to elucidate on these differences.

    Shivani Garg, MD, Department of Internal Medicine, Einstein Medical Center, Philadelphia, PA, Gentry King, MD, Medicine, Einstein Medical Center, Philadelphia, PA and Anthony Scarpaci, MD, Department of Hematology and Oncology, Albert Einstein Medical Center, Philadelphia, PA

    Disclosures:

    S. Garg, None

    G. King, None

    A. Scarpaci, None

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