PMID- 25586682 OWN - NLM STAT- MEDLINE DCOM- 20160125 LR - 20181113 IS - 1537-6591 (Electronic) IS - 1058-4838 (Print) IS - 1058-4838 (Linking) VI - 60 IP - 9 DP - 2015 May 1 TI - Use of boosted protease inhibitors reduces Kaposi sarcoma incidence among male veterans with HIV infection. PG - 1405-14 LID - 10.1093/cid/civ012 [doi] AB - BACKGROUND: Kaposi sarcoma (KS) incidence has decreased since combination antiretroviral therapy (cART). However, effects of cART type and duration on KS remain difficult to interpret secondary to KS-associated immune reconstitution inflammatory syndrome (IRIS). METHODS: We performed a retrospective study of Veterans Affairs Human Immunodeficiency Virus Clinical Case Registry data from 1985 to 2010. We analyzed the relationship between cART regimens and KS using multivariable Poisson regression, stratified or adjusted for timing around cART initiation. KS was identified by >/= 1 inpatient or >/= 2 outpatient International Classification of Diseases, Ninth Revision codes (176.0-9). Percent of cART on specific regimen and total duration on specific regimen were examined. RESULTS: There were 341 KS cases among 25 529 HIV-infected male veterans (incidence rate = 2.02/1000 person-years). Stratified by years after starting cART, every additional 10% time on boosted protease inhibitors (BPIs) was associated with reduced KS incidence in the third year of cART (incidence rate ratio [IRR] = 0.79; 95% confidence interval [CI], .69-.90). Months on BPIs was associated with lower KS incidence (P = .02). KS incidence was lower at 12-23 (IRR = 0.47; 95% CI, .23-.95) and >/= 36 (IRR = 0.14; 95% CI, .02-1.00) months on BPIs compared with <6 months. Longer duration on other regimens was not associated with decreased KS incidence. CONCLUSIONS: Lower KS incidence was observed with longer BPI use, after accounting for potential IRIS and other factors. Future research should evaluate newer cART regimens and long-term benefits of PI-based cART on KS in other cohorts and prospective studies. CI - (c) The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com. FAU - Kowalkowski, Marc A AU - Kowalkowski MA AD - Carolinas Healthcare System, Levine Cancer Institute College of Health and Human Services, University of North Carolina at Charlotte. FAU - Kramer, Jennifer R AU - Kramer JR AD - Department of Medicine, Baylor College of Medicine Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas. FAU - Richardson, Peter R AU - Richardson PR AD - Department of Medicine, Baylor College of Medicine Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas. FAU - Suteria, Insia AU - Suteria I AD - Department of Medicine, Baylor College of Medicine Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas. FAU - Chiao, Elizabeth Y AU - Chiao EY AD - Department of Medicine, Baylor College of Medicine Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas. LA - eng GR - P30CA125123-04S1/CA/NCI NIH HHS/United States GR - R01 CA163103/CA/NCI NIH HHS/United States GR - AI036211/AI/NIAID NIH HHS/United States GR - P30 CA125123/CA/NCI NIH HHS/United States GR - P30 AI036211/AI/NIAID NIH HHS/United States GR - R01CA163103/CA/NCI NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20150113 PL - United States TA - Clin Infect Dis JT - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JID - 9203213 RN - 0 (HIV Protease Inhibitors) SB - IM MH - Adult MH - *Antiretroviral Therapy, Highly Active MH - HIV Infections/*drug therapy MH - HIV Protease Inhibitors/adverse effects/*therapeutic use MH - Humans MH - Immune Reconstitution Inflammatory Syndrome/complications MH - Incidence MH - Male MH - Middle Aged MH - Poisson Distribution MH - Prospective Studies MH - Regression Analysis MH - Retrospective Studies MH - Risk Factors MH - Sarcoma, Kaposi/*epidemiology MH - Veterans MH - Young Adult PMC - PMC4462659 OTO - NOTNLM OT - Kaposi sarcoma OT - combination antiretroviral therapy OT - human immunodeficiency virus OT - risk assessment OT - veterans EDAT- 2015/01/15 06:00 MHDA- 2016/01/26 06:00 PMCR- 2016/05/01 CRDT- 2015/01/15 06:00 PHST- 2014/10/07 00:00 [received] PHST- 2014/12/16 00:00 [accepted] PHST- 2015/01/15 06:00 [entrez] PHST- 2015/01/15 06:00 [pubmed] PHST- 2016/01/26 06:00 [medline] PHST- 2016/05/01 00:00 [pmc-release] AID - civ012 [pii] AID - 10.1093/cid/civ012 [doi] PST - ppublish SO - Clin Infect Dis. 2015 May 1;60(9):1405-14. doi: 10.1093/cid/civ012. Epub 2015 Jan 13.