HIV-1-ASSOCIATED KAPOSIS-SARCOMA IN A PREDOMINANTLY BLACK-POPULATION AT AN INNER-CITY HOSPITAL

Background. Kaposi's sarcoma (KS) associated with human immunodeficien cy virus type 1 (HIV-1) is the most common malignancy in patients with AIDS. It has been most commonly reported in white homosexual men, tho ugh a few cases have been reported in blacks,. Methods. We conducted a retrospective analysis of all HIV-1 seropositive patients with biopsy -proven KS seen at Howard University Hospital between February 1985 an d June 1995. Results. Of the 73 patients identified, 66 (90%), 4 were white, 2 were Hispanic, and 1 was of unidentified race. The median age was 32 years. Forty-eight (66%) were homosexual or bisexual men, and 10 (14%) were homosexual or bisexual with a history of intravenous dru g use (IDU). A history of IDU or blood transfusion was the only risk f actor in 7 (9%) and 2 (3%), respectively. The other 6 (8)% were hetero sexual. The median survival was 2.2 years. A CD4 count <200 and the pr esence of an opportunistic infection were associated with shortened su rvival. Conclusions. The predominant risk factor for HIV-1-associated KS was homosexual or bisexual activity. Only a few women with KS were identified, and they also reported sexual transmission from male bisex uals and/or drug users. Poor survival was associated with CD4 <200, st age III and IV KS at presentation, and opportunistic infections.