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2030-12-31
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- INI - Artigos de Periódicos [3645]
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MORTALITY AND ASSOCIATED RISK FACTORS AMONG PEOPLE LIVING WITH HIV WITH KAPOSI SARCOMA: A5263/AMC066 AND A5264/AMC067
Author
Chagomerana, Maganizo B.
Moser, Carlee B.
Kang, Minhee
Umbleja, Triin
Hughes, Michael D.
Campbell, Thomas B.
Krown, Susan E.
Borok, Margaret Z.
Samaneka, Wadzanai
Ngongondo, McNeil
Nyirenda, Mulinda
Langat, Deborah C.
Hoagland, Brenda
Burger, Henriette
Busakhala, Naftali
Njiru, Evangeline
Mwelase, Noluthando
Mngqibisa, Rosie
Hosseinipour, Mina C.
Moser, Carlee B.
Kang, Minhee
Umbleja, Triin
Hughes, Michael D.
Campbell, Thomas B.
Krown, Susan E.
Borok, Margaret Z.
Samaneka, Wadzanai
Ngongondo, McNeil
Nyirenda, Mulinda
Langat, Deborah C.
Hoagland, Brenda
Burger, Henriette
Busakhala, Naftali
Njiru, Evangeline
Mwelase, Noluthando
Mngqibisa, Rosie
Hosseinipour, Mina C.
Affilliation
UNC Project. Lilongwe, Malawi / University of North Carolina at Chapel Hill. UNC Department of Medicine. Chapel Hill, NC, USA.
Harvard T. H. Chan School of Public Health. Center for Biostatistics in AIDS Research. Boston, MA, USA.
Harvard T. H. Chan School of Public Health. Center for Biostatistics in AIDS Research. Boston, MA, USA.
Harvard T. H. Chan School of Public Health. Center for Biostatistics in AIDS Research. Boston, MA, USA.
Harvard T. H. Chan School of Public Health. Center for Biostatistics in AIDS Research. Boston, MA, USA.
University of Colorado School of Medicine. Aurora, CO, USA.
Memorial Sloan-Kettering Cancer Center (Emerita). New York, NY, USA.
University of Zimbabwe. Faculty of Medicine and Health Sciences. Harare, Zimbabwe.
University of Zimbabwe. Faculty of Medicine and Health Sciences. Harare, Zimbabwe.
UNC Project. Lilongwe, Malawi.
Kamuzu University of Health Sciences. Johns Hopkins Research Project. Blantyre, Malawi.
Kenya Medical Research Institute/Walter Reed Project. Kericho, Nairobi, Kenya.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST e AIDS. Rio de Janeiro, RJ, Brasil.
Stellenbosch University and Tygerberg Academic Hospital. Faculty of Medicine and Health Sciences. Cape Town, South Africa.
Moi University Clinical Research Centre. Kenya.
Moi University Clinical Research Centre. Kenya.
University of Witwatersrand. Johannesburg, South Africa.
DICRS. Enhancing Care Foundation. Durban, South Africa.
UNC Project. Lilongwe, Malawi / University of North Carolina at Chapel Hill. UNC Department of Medicine. Chapel Hill, NC, USA.
Harvard T. H. Chan School of Public Health. Center for Biostatistics in AIDS Research. Boston, MA, USA.
Harvard T. H. Chan School of Public Health. Center for Biostatistics in AIDS Research. Boston, MA, USA.
Harvard T. H. Chan School of Public Health. Center for Biostatistics in AIDS Research. Boston, MA, USA.
Harvard T. H. Chan School of Public Health. Center for Biostatistics in AIDS Research. Boston, MA, USA.
University of Colorado School of Medicine. Aurora, CO, USA.
Memorial Sloan-Kettering Cancer Center (Emerita). New York, NY, USA.
University of Zimbabwe. Faculty of Medicine and Health Sciences. Harare, Zimbabwe.
University of Zimbabwe. Faculty of Medicine and Health Sciences. Harare, Zimbabwe.
UNC Project. Lilongwe, Malawi.
Kamuzu University of Health Sciences. Johns Hopkins Research Project. Blantyre, Malawi.
Kenya Medical Research Institute/Walter Reed Project. Kericho, Nairobi, Kenya.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST e AIDS. Rio de Janeiro, RJ, Brasil.
Stellenbosch University and Tygerberg Academic Hospital. Faculty of Medicine and Health Sciences. Cape Town, South Africa.
Moi University Clinical Research Centre. Kenya.
Moi University Clinical Research Centre. Kenya.
University of Witwatersrand. Johannesburg, South Africa.
DICRS. Enhancing Care Foundation. Durban, South Africa.
UNC Project. Lilongwe, Malawi / University of North Carolina at Chapel Hill. UNC Department of Medicine. Chapel Hill, NC, USA.
Abstract
Background: AIDS-related Kaposi sarcoma (AIDS-KS) remains a leading cause of morbidity and mortality among people living with HIV in Africa. Mortality among people with AIDS-KS on antiretroviral therapy remains high compared with people on antiretroviral therapy who do not have AIDS-KS. Setting: People living with HIV with Kaposi sarcoma (KS) who participated in 2 randomized trials (A5263/AMC066 [advanced stage] and A5264/AMC067 [mild-to-moderate stage]) conducted by AIDS Clinical Trials Group/AIDS Malignancy Consortium in low- and middle-income countries. Methods: We estimated mortality rates over the trial period. Cox proportional hazards regressions were used to identify baseline characteristics associated with mortality and compared mortality rates between participants who had KS progression within 12 weeks of treatment initiation (early progression of KS [KS-PD]) and those who did not. Results: Of the 329 and 189 eligible participants in A5263/AMC066 and A5264/AMC067, 71 (21.6%) and 24 (12.7%) died, respectively. In both trials, hypoalbuminemia was associated with increased hazards of death compared with normal albumin; A5263/AMC066: mild hypoalbuminemia (adjusted hazard ratio [aHR] = 3.01; 95% CI: 1.42 to 6.29), moderate hypoalbuminemia (aHR = 5.11; 95% CI: 2.54 to 10.29), and severe hypoalbuminemia (aHR = 14.58; 95% CI: 6.32 to 35.60), and A5264/AMC067: mild hypoalbuminemia (aHR = 5.66; 95% CI: 1.90 to 16.93) and moderate hypoalbuminemia (aHR = 7.02; 95% CI: 2.57 to 19.15). The rate of death was higher among participants who had early KS-PD than those without early KS-PD in A5263/AMC066 (HR = 5.09; 95% CI: 1.71 to 15.19) but not in A5264/AMC067 (HR = 1.74; 95% CI: 0.66 to 4.62). Conclusions: Albumin measurements may be used to identify individuals at higher risk of death after initiating KS treatment and for evaluation of interventions that can reduce AIDS-KS mortality.
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