Children with HIV have an increased incidence of malignancies, commonly Non Hodgkins lymphoma (NHL). Recent advances in treatment of HIV such as use of the newer protease inhibitors: eg- Nelfinavir (NLF) and Indinavir (IND) with two other agents (triple therapy), also called HAART, has radically changed the outlook for the disease. We saw 7 children with cancer over a 6 year period(Ages 2-9 years). All were perinatally infected with HIV. 5/7 had NHL and one each had Hodgkins Disease(H.D.) and low grade leiomyosarcoma. 4/5 with NHL died (Median survival 13 weeks; Mean 18.2 weeks) and 1/5 with NHL and 2 others surviving are currently on HAART. The clinical profile of these patients including Karnofsky performance scale scores (K. Score) is presented in the table below.

Table 1 No caption available.
Full size table

The improvements in viral load, CD4 counts and Karnofsky scores demonstrate the obvious impact of HAART on duration and quality of life in this group of patients. This improvement of prognosis in the HAART era emphasizes the need for aggressive therapy for cancer in children with HIV infection.(COMP= Cyclophosphamide,Vincristine,Methotrexate and Prednisone; N.D.= Not Done; COPP-ABV= Cyclophosphamide,Vincristine,Procarbazine,Prednisone- Adriamycin,Bleomycin and Vinblastine)