{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T19:37:37Z","timestamp":1783971457859,"version":"3.55.0"},"posted":{"date-parts":[[2024,8,28]]},"group-title":"HIV\/AIDS","reference-count":44,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T00:00:00Z","timestamp":1724803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2024,8,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Despite widespread access to antiretroviral therapy (ART) in the \u201cTreat All\u201d era, HIV-associated Kaposi sarcoma (KS) remains among the most common malignancies in sub-Saharan Africa. Survival after KS diagnosis has historically been poor in Africa, but knowledge whether survival has changed at the population level in the contemporary era has been limited by lack of community-representative surveillance and monitoring systems.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We identified all adult persons living with HIV (PLWH) with a new diagnosis of KS made between 2016 and 2019 during outpatient or inpatient care at prototypical primary care-providing medical facilities in Kenya and Uganda using rapid case ascertainment. Participants were subsequently followed for vital status, including community tracking for those who became lost to follow-up.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Findings<\/jats:title>\n                  <jats:p>Among 411 participants with newly diagnosed KS, 71% were men, median age was 34 (IQR: 30 to 41) years, and 91% had ACTG T1 tumor extent. Over a median follow-up of 7.8 (IQR: 2.4 to 17.9) months, cumulative incidence of death (95% CI) at months 6, 12 and 18 were 34% (30% to 39%), 41% (36% to 46%) and 45% (40% to 51%), respectively. Having the highest number of anatomic sites (11 to 16) harboring KS lesions (hazard ratio 2.2 (95% CI: 1.3-3.8) compared to 1 to 3 sites) and presence of oral KS lesions (hazard ratio 2.2 (95% CI: 1.4-3.3)) were independently associated with higher mortality. Lower hemoglobin and CD4 count as well as higher plasma HIV RNA were also associated with higher mortality.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Interpretation<\/jats:title>\n                  <jats:p>Among PLWH with newly diagnosed KS in East Africa in the \u201cTreat All\u201d era, survival was poor and related to mucocutaneous extent of KS. The findings emphasize the need for better control of KS in Africa, including novel approaches for earlier detection, better linkage to oncologic care, and more potent therapy.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2024.08.26.24312536","type":"posted-content","created":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T11:40:12Z","timestamp":1724845212000},"source":"Crossref","is-referenced-by-count":5,"title":["Survival Following Diagnosis of HIV-Associated Kaposi Sarcoma Among Adults in East Africa in the \u201cTreat-All\u201d Era"],"prefix":"10.64898","author":[{"given":"Helen","family":"Byakwaga","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aggrey","family":"Semeere","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Laker-Oketta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naftali","family":"Busakhala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Freeman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elyne","family":"Rotich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Wenger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippa","family":"Kadama-Makanga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Job","family":"Kisuya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Semakadde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bronia","family":"Mwine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Kasozi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bwana","family":"Mwebesa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toby","family":"Maurer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David V.","family":"Glidden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kara Wools-","family":"Kaloustian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Kambugu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Martin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2024083006050570000_2024.08.26.24312536v1.1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-199912240-00012"},{"key":"2024083006050570000_2024.08.26.24312536v1.2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.2910540106"},{"key":"2024083006050570000_2024.08.26.24312536v1.3","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.ijid.2020.10.020","article-title":"The impact of the South African antiretroviral treatment programme on the age-standardised incidence rate of Kaposi sarcoma, 1999-2016: An interrupted time series analysis","volume":"102","year":"2021","journal-title":"Int J Infect Dis"},{"key":"2024083006050570000_2024.08.26.24312536v1.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2021.02.758"},{"key":"2024083006050570000_2024.08.26.24312536v1.5","doi-asserted-by":"publisher","DOI":"10.1177\/0141076814554671"},{"key":"2024083006050570000_2024.08.26.24312536v1.6","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"issue":"1","key":"2024083006050570000_2024.08.26.24312536v1.7","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1179\/136485905X19928","article-title":"Kaposi\u2019s sarcoma in patients with and without human immunodeficiency virus infection, in a tertiary referral centre in Kenya","volume":"99","year":"2005","journal-title":"Ann Trop Med Parasitol"},{"key":"2024083006050570000_2024.08.26.24312536v1.8","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.20606"},{"key":"2024083006050570000_2024.08.26.24312536v1.9","unstructured":"(WHO) WHO. 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