       Document 3210
 DOCN  M94A3210
 TI    Is the cofactor associated with Kaposi's sarcoma in HIV infected
       homosexual men declining over time?
 DT    9412
 AU    Veugelers PJ; Strathdee SA; Moss AR; Page KA; Tindall B; Schechter MT;
       Coutinho RA; van Griensven GJ; Municipal Health Service, Dept of Public
       Health, Amsterdam, The; Netherlands.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):128 (abstract no. PA0132). Unique
       Identifier : AIDSLINE ICA10/94369365
 AB    OBJECTIVE: A decline in the proportion of Kaposi's sarcoma (KS) among
       incident AIDS cases has been reported. This has led to suggestions
       regarding a decreasing exposure to an hypothesized agent. However,
       recent studies show that the incidences of KS has remained relatively
       stable since the beginning of the epidemic. We aimed to studied this
       paradox by examining progression rates of KS relative to other AIDS
       conditions (nonKS-AIDS) among 407 homosexual men with documented dates
       of seroconversion in cohorts in Vancouver, Sydney, Amsterdam and San
       Francisco. METHODS: We performed a simulation to evaluate the
       proportionality of the incidence rates of KS relative to nonKS-AIDS.
       Additionally, we performed Kaplan-Meier and Cox proportional hazards
       analyses to determine whether progression rates of KS were different
       among recently infected men relative to men who became infected earlier
       in the epidemic. RESULTS: Among the 407 seroconverters, 139 (34%) were
       diagnosed with AIDS. 37 of whom had KS. Progression rates of KS and
       nonKS-AIDS were not proportional and were mediated by different factors.
       During the first years following seroconversion the probability of
       developing KS was elevated, whereas in later stages the opposite was
       observed. Recent seroconverters did not demonstrate a slower progression
       rate to KS' relative to earlier seroconverters. CONCLUSIONS: Our data
       suggest that the decline in the proportion of KS among incident AIDS
       cases is an artifact arising from non-proportionality. While our data do
       not argue for or against the existence of cofactor(s) in the etiology of
       KS, they do not support earlier suggestions that exposure to such
       factor(s) is declining over time.
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS/EPIDEMIOLOGY  Cohort
       Studies  Follow-Up Studies  *Homosexuality  Human  HIV Seropositivity
       Incidence  Male  Probability  Proportional Hazards Models  Sarcoma,
       Kaposi's/*EPIDEMIOLOGY/*ETIOLOGY  Survival Analysis  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

