Effect of highly active antiretroviral therapy on survival among HIV-infected men with Kaposi sarcoma or non-Hodgkin lymphoma

Henry K. Tam, Zuo Feng Zhang, Lisa P. Jacobson, Joseph B. Margolick, Joan S. Chmiel, Charles Rinaldo, Roger Detels

Research output: Contribution to journalArticle

Abstract

The effect of highly active antiretroviral therapy (HAART) on survival in HIV-infected patients with Kaposi sarcoma (KS) or non-Hodgkin lymphoma (NHL) is unknown. Our study examines survival after HAART for these 2 malignancies. Analyses were performed using data from 387 HIV-infected men in the Multicenter AIDS Cohort Study (MACS) after a diagnosis of either KS or NHL in 1990-99. Potential prognostic factors, including HAART, were evaluated in univariate analyses using Kaplan-Meier survival curves and logrank tests. Multivariate survival analyses were conducted using Cox's time-dependent proportional hazards models, adjusting for CD4+ cell levels at the time of cancer diagnosis and other covariates. Forty-three of 287 KS patients (15%) and 13 of 100 NHL patients (13%) had been treated with HAART. HAART treatment was associated with improved survival for KS and NHL patients (log-rank p = 0.0001 for each group). In multivariate analyses, HAART was associated with an 81% reduced risk of death among KS patients [relative hazard (RH) 0.19, 95% confidence limits (CL) (0.08, 0.45)], compared to those not exposed to HAART and an 84% reduced risk [RH 0.16, 95% CL (0.04, 0.64)] among NHL patients. Relative hazards estimates were similar for those with HAART initiation before and after NHL diagnosis. The use of HAART prolongs overall survival among HIV-positive men diagnosed with KS and NHL. HAART appears to be effective in improving survival even when initiated after the diagnosis of NHL and KS.

Original languageEnglish (US)
Pages (from-to)916-922
Number of pages7
JournalInternational Journal of Cancer
Volume98
Issue number6
DOIs
StatePublished - Apr 20 2002

Keywords

  • AIDS
  • Highly active antiretroviral therapy
  • Kaposi sarcoma
  • Multicenter AIDS Cohort Study
  • Non-Hodgkin lymphoma
  • Relative hazards
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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