Effect of highly active antiretroviral therapy on the incidence of HIV-associated malignancies at an urban medical center

The widespread use of highly active antiretroviral therapy (HAART) since 19 96 has led to a substantial decline in morbidity and mortality in patients infected with HIV, although its effect on the incidence of HIV-associated m alignancies is unknown. We retrospectively reviewed the annual number of ou tpatient visits to our HIV clinic, inpatient admissions for HIV disease, an d first admissions for patients with cancer and HIV disease at our center b etween 1990 and 1997. Between 1990 and 1995, there was a progressive increa se in the annual number of admissions for HIV disease and HIV-associated ca ncers that paralleled the increasing HIV clinic volume. In 1997, however, t he annual number of first admissions for Kaposi's sarcoma (KS) and non-Hodg kin's lymphoma compared with 1995 decreased by 36% and 63%, respectively, d espite a continued increase in the annual number of HIV clinic visits. Simi lar declines were also noted in the number of new cases of biopsy-confirmed KS and primary central nervous system (CNS) lymphoma. In contrast, there w as no decrease in the number of first admissions for patients with HIV infe ction and other cancers not typically associated with HIV infection. These findings suggest a declining incidence of HN-associated malignancies since the introduction of HAART.