Determinants of Mortality and Disease Progression of Kaposi Sarcoma in a Primary care ART Programme in Khayelitsha, South Africa

Discussion and conclusions  The prevalence of diagnosed KS among patients starting ART in Khayelitsha was low. However, the high proportion of high risk disease (T1S1) could be explained by a combination of late presentation and under-diagnosis of low risk disease.  Despite the advent of ART and the availability of chemoand radiotherapy mortality remained high.  Loss to follow-up before and after initiation of treatment was higher than in non-KS HIV-infected patients.  The major determinant for mortality and disease progression was advanced disease (stage T1 or S1), with systemic symptoms (stage S1) being associated with higher mortality and stage T1 with increased disease progression.  Addition of chemotherapy to ART was independently associated with a 70% decrease in mortality.  Improved studies on the effectiveness of accessible chemotherapy regimens and related side-effects in resource-limited settings are needed.  Efforts to improve early diagnosis and retention in care for patients with KS are also needed. Background & Setting Baseline Characteristics of Patients with Kaposi sarcoma