Background: A high proportion of HIV-infected patients are diagnosed with a malignancy sometime during the course of their HIV disease. Of the 2,754 HIV+ subjects enrolled in the Multicenter AIDS Cohort Study (MACS), 657 have been diagnosed with AIDS-malignancies. Although an association between the use of highly active anti-retroviral therapy (HAART) and the recent decline in incidence of AIDS-malignancies was reported, few studies have evaluated the effect of HAART on survival from AIDS-malignancies. Methods: Longitudinal data from the MACS were used to evaluate the effect of HAART on survival among HIV+ subjects with a diagnosis of cancer. Survival analyses were conducted using Cox's proportional hazards model. Results: Median survival for KS (N=484), lymphoma (N=104), and other cancers (N=69) were 16 months, 4 months, and 36 months, respectively. The median survival was 11 months (N=598) among those not exposed to HAART and not yet reached for those exposed to HAART (p-value by log-rank test is 0.0001). Log-rank tests comparing persons exposed to HAART to those not exposed resulted in a p-value of 0.0001, irrespective of the cancer type. The relative risk of death from all causes for those having no exposure to HAART, compared to those exposed to HAART, was 2.4 (95% C.I.=.78, 7.7). Conclusion: This suggests that use of highly active anti-retroviral agents may prolong overall survival among HIV positive patients diagnosed with AIDS-malignancies. This association appears to be true for each of the three AIDS-related malignancies.
Learning Objectives: At the conclusion of this session, participants will be able to identify the potential survival benefits of potent anti-retroviral agents for HIV-positive patients diagnosed with cancer
Keywords: Antiretroviral Combination Therapy, Cancer
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.