KAPOSIS-SARCOMA IN WOMEN WITH AIDS

Objective: To describe the presentation and incidence of Kaposi's sarc oma (KS) in a cohort of women infected with HIV and to compare their c linical characteristics with men at the same institution. Design: Retr ospective chart and database review. Setting: Adult clinical AIDS prog ram outpatient clinics at a municipal teaching hospital. Results: One hundred and seven people with KS were found of whom twelve (11.2%) wer e women. The prevalence of KS in women was 3.6% compared with 9.9% amo ng men (P < 0.001). Women born outside the United States were at incre ased risk of developing KS (P < 0.05). At initial KS presentation, no difference in HIV stage or CD4 count was found between men and women. Women presented with more advanced KS than men, with increased inciden ce of non-cutaneous disease (P < 0.001), lymphedema (P < 0.0001), lymp h-node disease (P < 0.0001) and visceral disease (P = 0.03). Women had decreased survival after KS diagnosis compared to men, although the d ifference was not significant (P = 0.41). Conclusions: KS is not a rar e diagnosis in HIV-infected women followed at our institution. Althoug h the increased risk of KS in men is most likely to be related to diff erences in exposure, the sex-related differences in presentation and c ourse may be due in part to delay in diagnosis. KS should be considere d in the spectrum of HIV-related complications in women as well as in men.