Survival after diagnosis

Despite the elevated incidence of many types of cancers in HIV-positive people, a number of studies have reported that survival rates have increased since the introduction of highly active antiretroviral therapy (HAART) in 1996.

For example, a comprehensive analysis of survival rates in AIDS patients with cancer in New York City between 1980 and 2000 showed significant improvement in survival for the AIDS-related cancer non-Hodgkin lymphoma, as well as the non-AIDS-related cancers colorectal, anal and breast cancer.

Although survival rates were similar between patients with and without AIDS for the period 1996 to 2000 for some cancers, such as Kaposi's sarcoma and cervical cancer, survival rates for others continued to lag behind patients without AIDS. These cancers included lung cancer and large cell diffuse lymphoma, a type of non-Hodgkin's lymphoma.1

Other recently published studies support the findings of the New York study, showing links between the use of HAART and lymphoma survival. A French study that looked 28 AIDS patients with the rare non-Hodgkin's primary effusion lymphoma found two factors linked to poorer outcome: poor performance status (a measure of the ability to carry out normal daily activities) and the absence of effective HAART.2

Similarly, a larger study of 363 patients with AIDS-related lymphoma found that survival of patients with diffuse large cell lymphoma increased in the HAART era. In contrast, however, survival of Burkitt lymphoma patients with AIDS remains poor and that poor survival is related to low CD4 cell counts.3

This finding was in agreement with a sub-study of the PETHEMA-LAL3/97 study, showing significantly better two-year survival in Burkitt lymphoma patients with a successful virological response to HAART, compared to those who did not reach viral loads below 80 copies/ml.4

See also Lung cancer.

References

  1. Biggar RJ et al. Survival after cancer diagnosis in persons with AIDS. J Acquir Immune Defic Syndr 39: 293-299, 2005
  2. Boulanger E et al. Prognostic factors and outcome of human herpesvirus 8-associated primary effusion lymphoma in patients with AIDS. J Clin Oncol 23: 4372-4280, 2005
  3. Lim ST et al. AIDS-related Burkitts lymphoma versus diffuse large-cell lymphoma in the pre-highly active antiretroviral therapy (HAART) and HAART eras: significant differences in survival with standard chemotherapy. J Clin Oncol 23: 4430-4438, 2005
  4. Oriol A et al. Highly active antiretroviral therapy and outcome of AIDS-related Burkitts lymphoma or leukemia. Results of the PETHEMA-LAL3/97 study, 2005
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