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Date Posted: 12:15:34 05/16/02 Thu
Author: Anonymous
Subject: HAART Reduces Mortality in HIV-Related Malignancy

http://www.medscape.com/viewarticle/432622_print

HAART Reduces Mortality in HIV-Related Malignancy

Reuters Health Information 2002. � 2002 Reuters Ltd
Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.
Introduction
NEW YORK (Reuters Health) Apr 24 - Highly active antiretroviral therapy (HAART) is associated with prolonged survival of HIV-infected men diagnosed with Kaposi sarcoma (KS) or non-Hodgkin lymphoma (NHL), even when it is initiated after diagnosis of the cancer.

Dr. Roger Detels, of the University of California, Los Angeles, and associates reviewed data from the Multicenter AIDS Cohort Study to identify 287 men with KS and 100 with NHL diagnosed between 1990 and 1999.

As reported in the International Journal of Cancer for April 20, the median survival time was 13 months for KS patients never exposed to HAART. Survival was significantly different (P =0.0001) for the two patients in whom HAART was initiated before diagnosis of KS and the 41 in whom HAART was initiated afterward, for whom the median survival time had not been reached by December of 1999.

After adjusting for year of KS diagnosis and baseline CD4 cell count, HAART exposure resulted in an 81% drop in mortality risk.

Eight-seven individuals with NHL were never treated with HAART, and for them, the median overall survival was 3 months. Among those who received HAART, four men died at 3, 4, 6 and 83 months after diagnosis of the malignancy. The nine other patients had survived for a median of 28 months by the end of 1999.

In this group, the reduction in the risk of death was 84%.

The investigators attribute the effect of HAART on survival to the enhanced ability of patients to tolerate higher doses of chemotherapy.

"Given the short expected median non-HAART survival...and the advanced stage at which most NHL cases are diagnosed, it was particularly encouraging to find that treatment with HAART resulted in prolonged survival," Dr. Detels and his colleagues write.

For both types of cancer, they recommend serious consideration of HAART treatment even after diagnosis.

Int J Cancer 2002;98:916-922.

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