Risk factors for Kaposi's sarcoma in HIV-positive subjects in Uganda.

ABSTRACT

PIP: The risk factors for Kaposi's sarcoma in HIV-infected persons were investigated in a case-control study conducted in Kampala, Uganda, in 1994-96. Cases included 458 HIV-positive Ugandans with newly diagnosed Kaposi's sarcoma, while the control group was comprised of 568 seropositive subjects without Kaposi's sarcoma. Men and women with Kaposi sarcoma were significantly more likely than controls to have a higher educational level, have prestigious professional or military jobs, to come from large settlements (over 1000 houses), to have a high household income, to travel away from home more than seven nights per year, and to have spent increasing time in contact with water. In addition, cases were more likely than controls to be married to one rather than several spouses and to have a history of a sexually transmitted disease. Indices of sexual behavior, including reported number of sexual partners and condom use, were unrelated to Kaposi's sarcoma risk. The higher socioeconomic status of HIV-infected persons with Kaposi's sarcoma may be a marker for enhanced exposure to a sexually transmitted agent such as human herpes virus-8 or for delayed exposure to a childhood infection. The puzzling association between exposure to water and Kaposi's sarcoma warrants further investigation.