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Effect of highly active antiretroviral therapy on survival among HIV‐infected men with Kaposi sarcoma or non‐Hodgkin lymphoma
Author(s) -
Tam Henry K.,
Zhang ZuoFeng,
Jacobson Lisa P.,
Margolick Joseph B.,
Chmiel Joan S.,
Rinaldo Charles,
Detels Roger
Publication year - 2002
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.10274
Subject(s) - medicine , proportional hazards model , hazard ratio , lymphoma , sarcoma , survival analysis , cohort , oncology , confidence interval , pathology
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 log‐rank 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. © 2002 Wiley‐Liss, Inc.