Kaposi's sarcoma and non‐hodgkin's lymphoma in european aids cases. no excess risk of kaposi's sarcoma in mediterranean countries

Abstract

Prior to the AIDS epidemic, Kaposi's sarcoma (non-AIDS-KS) in Europe was mainly a disease of elderly Mediterranean men. In 1989 AIDS data from 15 European countries were collected to study proportional trends in AIDS-related Kaposi's sarcoma (AIDS-KS) in order to determine whether specific factors in Southern Europe might be important in the development of KS among AIDS patients. Another AIDS-related cancer, non-Hodgkin's lymphoma (NHL) was included as a malignancy control. Of 22,367 AIDS cases reported, 3,779 (16.9%) were KS and 741 (3.3%) were NHL. A significant, continuous fall in the percentage of AIDS-KS was seen for both homosexual men and other members of exposure groups during the period 1981-89 (p-trend less than 0.0001). The proportion with AIDS-KS decreased from 40.5% in 1983 to 26.5% in 1988 in homosexual men and from 12.2 to 3.6% in other exposure groups, respectively. No significant change was observed in the proportion of NHL cases among any of the risk groups over time, although a tendency towards a slight increase was noted for homosexual men. Comparing proportional trends of KS and NHL geographically, no significant difference was found overall, by time or by exposure group. In conclusion, a specific decline is observed over time for AIDS-KS. However, if geographically-restricted factors are important in the development of non-AIDS-KS in Europe, the same factors do not appear to affect the risk of AIDS-KS.

The epidemiology of AIDS-associated non-Hodgkin's lymphoma in the World Health Organization European Region

“…In agreement with data from the United States, where 2,824 out of 97,258 AIDS cases (2.9%) had NHL (Beral et al, 1991), and with a similar study on AIDSassociated NHL in 15 European countries, where 3.3% of cases had NHL (Casabona et al, 1991), the results of the present study indicate that NHL is associated with 3.0% of AIDS cases in the WHO European Region. This figure is also similar to that found in other immunosuppressed groups not infected with HIV (Fraumeni & Hoover, 1977;Penn, 1986).…”

“…As already reported by Casabona et al (1991), also in the present study the proportions of AIDS cases with NHL were quite comparable in the different areas of Europe. The discrepant figures derived, however, only from countries (i.e., Eastern and Southern Europe) where the AIDS epidemic is still in a very early phase, and/or the accuracy in NHL diagnoses may be low (Jensen et al, 1990).…”

“…Interestingly, Epstein Barr virus (EBV) infection is consistently present in primary lymphomas of the central nervous system among AIDS patients (MacMahon et al, 1991), and also many of the AIDSassociated lymphomas classified as immunoblastic or Burkitt's lymphomas appear to be EBV-driven lymphoproliferations (Editorial, 1991 (Casabona et al, 1991).…”

Risk factors for Kaposi's-sarcoma-associated herpesvirus (KSHV/HHV-8) seropositivity in a cohort of homosexual men, 1981–1996

“…This decline in incidence is concomitant with a decline in sexual promiscuity and in the incidence of infection with HIV (Becker and Melbye, 1991;van Griensven et al, 1993). We earlier noted a decrease in KS rates among AIDS patients during the same period (Casabona et al, 1991). The uniform age distribution of KSHV/HHV-8 seropositivity in 1981 suggests that KSHV/HHV-8 only became highly prevalent in Danish homosexual men shortly before that time.…”

Comparison of the distribution of non-AIDS Kaposi’s sarcoma and non-Hodgkin’s lymphoma in Europe

“…The lack of an excess of AIDS-associated KS in southern Europe, despite the strong geographical predilection described for classic KS, has long been noticed (Casabona et al, 1991;Ebrahim et al, 1997;Franceschi et al, 1997) and remains unexplained. In fact, the prevalence of KS among AIDS patients in Europe accurately reflects the proportion of homosexual and bisexual men (highest in Denmark, the Netherlands and the United Kingdom) and of people from Africa (highest in Belgium, France and in the United Kingdom) (Dal Maso et al, 1995;Parkin et al, 1997).…”