589   Effect of HAART on Survival with Kaposi's Sarcoma and Non-Hodgkin's Lymphoma.

H. Tam¹, Z. Zhang¹, L. P. Jacobson², J. B. Margolick², L. Kingsley³, J. Chmiel⁴, and R. Detels*¹for the Multicenter AIDS Cohort Study.
¹Univ. of California at Los Angeles Sch. of Publ. Hlth.;²Johns Hopkins Sch. Of Publ. Hlth., Baltimore, MD;³Univ. of Pittsburgh Sch. of Publ. Hlth., PA; and⁴Northwestern Univ. Med. Sch., Chicago, IL.

Background:There is little data on the effect of HAART on survival with AIDS Kaposi's sarcoma (KS) and non-Hodgkin's lymphoma (NHL). This study examined survival after HAART with these two malignancies.

Methods:Survival analyses were performed using data from 357 HIV-positive men in the Multicenter AIDS Cohort Study (MACS) following a diagnosis of either KS or NHL. Potential prognostic factors, including HAART, were evaluated using Kaplan-Meier curves and log-rank tests. Multivariate survival analyses were performed using Cox time-dependent proportional hazards models, adjusting for CD4⁺cell levels at the time of cancer diagnosis and other covariates.

Results:Two hundred thirty-three of 276 KS cases (84.8%) and 12 of 81 NHL cases (14.8%) had been treated with HAART. HAART treatment was associated with improved survival among both KS and NHL cases (log-rank p < 0.0001 for both groups). The adjusted relative risk of death for those exposed to HAART was reduced by 82.6% (relative hazard [RH] = 0.174) compared to those not exposed to HAART among KS cases and by 80.7% (RH = 0.193) among NHL cases. The reduction was similar for those with HAART initiated before and after NHL diagnosis.

Conclusions:Use of HAART prolongs survival among AIDS patients with KS and NHL. Patients with these two malignancies not already on HAART should start it.