The world-wide incidence of Kaposi's sarcoma in the HIV/AIDS era

Z. Liu, Q. Fang, J. Zuo, Veenu Minhas, C. Wood, T. Zhang

Research output: Contribution to journalArticlepeer-review

49 Scopus citations


Objectives: Kaposi's sarcoma (KS) is a multicentric angioproliferative cancer of endothelial origin typically occurring in the context of immunosuppression or immunodeficiency. Consequently, KS is one of the most common cancers in HIV-infected individuals and frequently occurs among transplant recipients. Nevertheless, its incidence in different populations is not well understood. Methods: We searched online databases for publications on KS incidence. A random-effect meta-analysis was performed to combine the KS incidences and incidence rate ratios (IRRs) for associated risk factors. Results: Seventy-six eligible studies representing 71 time periods were included. For HIV-infected people, the overall KS incidence was 481.54 per 100 000 person-years with a 95% confidential interval (CI) of 342.36–677.32 per 100 000 person-years. HIV-infected men who have sex with men (MSM) had the highest incidence of KS (1397.11 per 100 000 person-years; 95% CI 870.55–2242.18 per 100 000 person-years). The incidence of KS was significantly lower in female than in male individuals (IRR 3.09; 95% CI 1.70–5.62). People receiving highly active antiretroviral therapy (HAART) had a lower incidence compared with people who had never received HAART (IRR 6.57; 95% CI 1.91–24.69). The incidence of KS was 68.59 (95% CI 31.39–149.86) per 100 000 person-years in transplant recipients, 52.94 (95% CI 39.90–70.20) per 100 000 person-years in children with HIV infection, and 1.53 (95% CI 0.33–7.08) per 100 000 person-years in the general population. Conclusions: Globally, a relatively high incidence of KS was found among HIV-seropositive people and, in particular, in HIV-infected MSM. The introduction of HAART has largely prevented the development of KS, but it has not entirely removed the challenge of KS. In Africa, in particular, KS imposes a very heavy disease burden, which can mainly be attributed to the high prevalence of KS-associated herpesvirus and poor access to HAART.

Original languageEnglish (US)
Pages (from-to)355-364
Number of pages10
JournalHIV Medicine
Issue number5
StatePublished - May 2018


  • Kaposi's sarcoma
  • incidence
  • meta-analysis

ASJC Scopus subject areas

  • Health Policy
  • Infectious Diseases
  • Pharmacology (medical)


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