Significance of HIV Viral Load and CD4 Count on Kaposi Sarcoma in the Era of Highly-Active-Antiretroviral Therapy
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.
A. Scarpaci, None