HIGH-INCIDENCE AND AGGRESSIVE GROWTH OF NON-AIDS-DEFINING CANCERS AMONG AIDS PATIENTS IN OSLO

The spectrum of cancers advanced by AIDS is disputed. To supplement th e register-based investigations, we have studied the occurrence of non -AIDS-defining malignancies in a closely followed population of AIDS p atients. The population comprises 255 patients fulfilling CDC's clinic al AIDS definition, representing 91% of all adult AIDS patients from O slo 1983-1995. Full autopsy was performed on 73% of the 211 fatal case s. Adding patients with CD4 cell counts below 200 cells/mm(3) to match the US AIDS definition, the population increases to 344, including 22 5 deceased. The expected number of cancer cases was calculated from ag e- and sex-specific cancer incidence rates for Oslo 1988-1992. The num ber of non-AIDS-defining cancers was six (clinical CDC criteria) or ei ght (US AIDS definition), compared to expected numbers of 0.54 and 1.0 , respectively. At autopsy, four of eight cases showed extensive tumor dissemination with involvement of the heart. These observations sugge st that (at least some) non-AIDS-defining cancers occur at increased r ates and show aggressive growth pattern in AIDS.