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Poor immune status and systemic disease are independently associated with mortality in AIDS-related Kaposi Sarcoma in Nigeria


AIDS-related Kaposi’s sarcoma (AIDS-KS) is the most common AIDS-associated malignancy and remains a significant cause of morbidity and mortality in sub-Saharan Africa. We describe the determinants of mortality among patients with AIDS-KS in a comprehensive HIV care and treatment program in Jos, Nigeria.

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We collected epidemiologic, clinical, staging and survival data for 357 patients with a diagnosis of AIDS-KS enrolling for HIV-care at the Jos University Teaching Hospital. Patients were staged according to the AIDS Clinical Trials Group (ACTG) criteria, which are based on the evaluation of tumor extension (T), CD4+ cell count (I), and patient’s systemic status (S), stratified by good (0) versus poor (1) risk. Information on survival was obtained through an active follow-up on verification of vital status of the patients. Survival analysis was computed by the Kaplan-Meier method, and the log-rank test was used to test the difference between subgroups.


During the period of the study (2004-2008), there were 197 women (55.2%) and 160 (44.8%) men with AIDS-related Kaposi Sarcoma. Their mean age was 37±8 years and the median follow-up was 15 months (1-49 months). The median CD4+ and viral load were 107cells/mm³ and 58,561copies/ml respectively at baseline. Only 42 (11.8%) were on HAART at KS diagnosis, however all patients were commenced on HAART in line with existing national guidelines subsequently. 262(74.4%) had poor immune system status (I1: CD4+<200cells/mm3), 77.5% had widespread tumor extension (T1) and 80.2% had systemic disease (S1). Poor immune system (I1) status (AOR 2.07, CI 1.25-3.42, p=0.002) and presence of systemic disease (S1) (AOR 2.10, CI 1.03-4.28, p=0.004) were independently associated with mortality.

Regarding ACTG classification, the 4-year survival rate was 67% for I0 vs 46% for I1 (p=0.05), 58% for S0 vs 49% for S1 (p=0.41), 60% for T0 vs 46% for T1 (p=0.19).


Poor immune status and systemic disease are independent predictors of mortality in patients with AIDS-KS in Nigeria.

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Correspondence to Patricia Agaba.

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This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Agaba, P., Sule, H., Ojoh, R. et al. Poor immune status and systemic disease are independently associated with mortality in AIDS-related Kaposi Sarcoma in Nigeria. Infect Agents Cancer 7 (Suppl 1), P7 (2012).

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