Table 2.
Kaposi Sarcoma (KS) Incidence Rates per 100 000 Person-Years and Hazard Ratios for Developing KS in Children and Adolescents who Initiated Combination Antiretroviral Therapy
| Characteristic | Patients (N) | Person- Years | Cases (N) | Incidence Rate (95% CI) | Crude HR (95% CI) | Adjusted HRa (95% CI) |
|---|---|---|---|---|---|---|
| Overall | 24 991 | 74 456 | 26 | 34.9 (23.8–51.3) | … | … |
| Region and origin | ||||||
| Eastern Africa | 11 163 | 23 313 | 20 | 85.8 (55.3–133.0) | 1.0 | 1.0 |
| Southern Africa | 9174 | 26 337 | 3 | 11.4 (3.7–35.3) | 0.2 (.0–.5) | 0.1 (.0–0.6) |
| Europe, SSA origin | 658 | 3694 | 3 | 81.2 (26.2–251.8) | 1.8 (.5–6.1) | 1.0 (.2–6.4) |
| Europe, non-SSA origin | 934 | 7428 | 0 | 0 (0–49.8) | … | … |
| Asia | 3062 | 13 684 | 0 | 0 (0–27.0) | … | … |
| Sex | ||||||
| Boys | 12 487 | 37 448 | 18 | 48.1 (30.3–76.3) | 1.0 | 1.0 |
| Girls | 12 504 | 37 009 | 8 | 21.6 (10.8–43.2) | 0.4 (.2–1.0) | 0.3 (.1–.9) |
| Age at cART initiation (y) | ||||||
| 0–4 | 12 409 | 34 923 | 7 | 20.0 (9.6–42.0) | 1.0 | 1.0 |
| 5–9 | 7506 | 25 431 | 7 | 27.5 (13.1–57.7) | 1.5 (.5–4.2) | 1.2 (.4–4.3) |
| 10–15 | 5076 | 14 102 | 12 | 85.1 (48.3–149.8) | 3.9 (1.5–10.0) | 3.4 (1.2–10.1) |
| Weight-for-age z score at cART initiationb | ||||||
| <−3 | 3799 | 9709 | 0 | 0 (0–38.1) | … | … |
| −3 to <−2 | 3712 | 10 408 | 2 | 19.2 (4.8–76.8) | 1.4 (.2–9.6) | … |
| −2 to <−1 | 4352 | 12 870 | 7 | 54.4 (25.9–114.1) | 3.9 (.8–19.0) | … |
| ≥−1 | 4739 | 15 817 | 2 | 12.6 (3.2–50.6) | 1.0 | … |
| Missing | 3313 | 11 550 | 3 | … | … | … |
| First-line cART regimen | ||||||
| Nonnucleoside reverse-transcriptase inhibitors based | 19 761 | 57 502 | 25 | 43.5 (29.4–64.3) | 1.0 | … |
| Protease inhibitor based | 4998 | 15 945 | 1 | 6.3 (.9–44.5) | 0.2 (.0–1.2) | … |
| Other cART | 232 | 1009 | 0 | … | … | … |
| Year of cART initiation | ||||||
| 1996–2003 | 1405 | 12 252 | 2 | 16.3 (4.1–65.3) | 1.0 | 1.0 |
| 2004–2007 | 11 360 | 44 121 | 18 | 40.8 (25.7–64.8) | 1.3 (.3–5.5) | 0.4 (.0–3.6) |
| 2008–2014 | 12 226 | 18 084 | 6 | 33.2 (14.9–73.9) | 0.5 (.1–2.8) | 0.2 (.0–2.1) |
| Centers for Disease Control and Prevention stage at cART initiation | ||||||
| A/B | 20 619 | 60 261 | 17 | 28.2 (17.5–45.4) | 1.0 | 1.0 |
| C | 2424 | 7027 | 4 | 56.9 (21.4–151.7) | 2.2 (.7–6.6) | 2.4 (.8–7.3) |
| Missing | 1948 | 7168 | 5 | … | … | … |
| CD4 cell count at cART initiation (cells/µL)c | ||||||
| <200 | 4592 | 15 331 | 8 | 52.2 (26.1–104.3) | 1.0 | … |
| ≥200 | 5980 | 18 265 | 5 | 27.4 (11.4–65.8) | 0.5 (.2–1.5) | … |
| Missing | 2010 | 5937 | 6 | … | … | … |
| CD4% at cART initiation | ||||||
| <10% | 6004 | 20 563 | 7 | 34.0 (16.2–71.4) | 1.0 | … |
| 10–19% | 7395 | 22 032 | 3 | 13.6 (4.4–42.2) | 0.4 (.1–1.4) | … |
| ≥20% | 4368 | 12 003 | 2 | 16.7 (4.2–66.6) | 0.4 (.1–2.1) | … |
| Missing | 7224 | 19 858 | 14 | … | … | … |
Abbreviations: cART, combination antiretroviral therapy; CI, confidence interval; HR, hazard ratio; SSA, sub-Saharan African.
a Adjusted for region and origin, sex, age, year of ART initiation, and Centers for Disease Control and Prevention stage at cART initiation. Number of children and adolescents included in multivariable model, N = 23 043.
b Weight-for-age z scores only calculated for children aged <10 years at time of measurement.
c Children aged <5 years were excluded from the analysis of CD4 cell counts.