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Is Kaposi's sarcoma occurring at higher CD4 cell counts over the course of the HIV epidemic?

Crum-Cianflone, Nancy Fa,b; Hullsiek, Katherine Hupplera,c; Ganesan, Anuradhaa,d; Weintrob, Amya,e; Okulicz, Jason Fa,f; Agan, Brian Kathe Infectious Disease Clinical Research Program HIV Working Group

doi: 10.1097/QAD.0b013e32833f9fb8
Research Letters

We evaluated longitudinal rates of Kaposi's sarcoma and trends in CD4 cell counts at the time of Kaposi's sarcoma diagnosis during the HIV epidemic (1985–2008). Although rates of Kaposi's sarcoma have decreased, cases are now occurring at higher CD4 cell counts over time, with more than one-third of cases diagnosed in 2002–2008 occurring at CD4 cell counts of at least 350 cells/μl. These data support future studies evaluating the impact of highly active antiretroviral therapy initiation at higher CD4 cell counts to further reduce Kaposi's sarcoma.

aInfectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA

bInfectious Disease Clinic, Naval Medical Center San Diego, San Diego, California, USA

cDivision of Biostatistics, University of Minnesota, Minneapolis, Minnesota, USA

dInfectious Disease Clinic, National Naval Medical Center, Bethesda, Maryland, USA

eInfectious Disease Clinic, Walter Reed Army Medical Center, Washington, District of Columbia, USA

fInfectious Disease Service, San Antonio Military Medical Center, San Antonio, Texas, USA.

Received 25 June, 2010

Revised 12 August, 2010

Accepted 18 August, 2010

Correspondence to Dr Nancy Crum-Cianflone, MD, MPH, Clinical Investigation Department (KCA), Naval Medical Center San Diego, 34800 Bob Wilson Drive, Ste. 5, San Diego, CA 92134-1005, USA. Tel: +1 619 532 6189 40; fax: +1 619 532 8137; e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.