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Kaposi sarcoma as indicator disease for HIV prevalence in the Netherlands

This population-based study examines the incidence, treatment patterns, and survival trends of Kaposi sarcoma in the Netherlands, highlighting its role as an indicator disease for HIV prevalence.

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Kaposi sarcoma as indicator disease for HIV prevalence in the Netherlands

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  1. Kaposi sarcoma as indicator disease for HIV prevalence in the Netherlands A population-based study 12th of June 2019 | Vincent Ho | Harm Buisman | Jan Maarten van der Zwan

  2. Disclosure

  3. Historical perspective • Moritz Kaposi (1837–1902) • 1872: The disease leads to death, and it does sowithin a short period of two to three years...The disease must, from our present experience,be considered from the onset not only asincurable but also as deadly. Source: www.zsidokivalosagok.hu

  4. Presentation • ‘classic’ form • elderly men; • skin lesions of lower extremities; • rarely nodal involvement; • indolent period 10–15 years; • systemic lesions or lymphoreticularmalignancies in late phase • African (‘endemic’) form • childhood form • transplant-associated form DePond, 2019

  5. Presentation II • AIDS epidemic: ‘HIV-associated’ form • 1980s: significant proportions of homosexual men with AIDS(San Francisco: 40%; Vancouver: 56% among those with >20 partners) • multicentric, more aggressive behavior • disseminations involving mucosal tissues, progress to visceral organs • 1996: Kaposi sarcoma caused by human herpesvirus 8 (HHV8) • 1990s: stark decline in incidence with highly active antiretroviral therapy (US: 50% reduction with triple antiretroviral therapy) Curtiss, 2016; Jones, 2000

  6. The Netherlands

  7. The Netherlands II • inhabitants: 17.3 million (2019) • total area: 41,500 sqkilometres (16,000 sq mi) • hospitals: 80 (approx)

  8. Netherlands Cancer Registry • since: national data since 1989 (regionalfrom 1955) • coverage: >95% • incidence: >115.000 cases per year • database: >2 million cases • data collection, analysis and reporting:Netherlands ComprehensiveCancer Organization (IKNL)

  9. Netherlands Cancer Registry II pathology laboratories NCR hospital discharge other databases

  10. Netherlands Cancer Registry III • basic data • demographics (birth date, sex, postal code) • tumor characteristics (topography, morphology) • information on diagnosis • information on treatment (type, hospital) • information on follow-up (includingvital status) • additional data (tumor specific) • e.g. molecular markers, complications, pathological review(depending on tumor type)

  11. Methods • case selection • primary Kaposi sarcoma (M9140), histologicallyconfirmed • diagnosis in a Dutch hospital, 1989–2018 • residency in the Netherlands • incidence • byregion; based on postal code(definedforstatistical purposes, as used by Statistics Netherlands)  • comparisonwith HIV-prevalence, byregion • treatment patterns • survival trends • age-standardized net survival

  12. Results overall

  13. Results overall II

  14. Resultsbysex

  15. Resultsbysex II

  16. Resultsbysex II

  17. Resultsbysex II

  18. Resultsbysex II

  19. Resultsbysex II

  20. Resultsbysex II

  21. Resultsbyregion

  22. Resultsbyregion

  23. Resultsbyregion

  24. Resultsbyregion

  25. Resultsbyregion

  26. Resultsbyregion

  27. HIV Monitoring • 2017

  28. Resultsbyregion

  29. Survival

  30. Conclusions • Incidence of Kaposi sarcoma has been predominantly centered around the nation’s capital area of Amsterdam, mirroring reported figures on HIV prevalence • Survival of Kaposi sarcoma patients improved considerably over time • In general, Kaposi sarcoma may be conceived as indicator disease for HIV prevalence

  31. Acknowledgements • Harm Buisman • Jan Maarten van der Zwan • team ‘Rare cancers’ • Annemiek Kwast • Ria de Peuter • Loes Verboord • Karin Fonken • Ria Jansen • Thekla Bluemink • Marlon Tonis

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