BACKGROUNDThe authors sought to determine whether the availability of highly active antiretroviral therapy (HAART) coincided with changes in the epidemiology of acquired immunodeficiency syndrome (AIDS)‐related non‐Hodgkin lymphoma (NHL).METHODSCancer registry data from 1988–2000 were linked with AIDS registry data from 1981 to July 2003 for San Diego County to identify 537 AIDS‐NHL patients. By using the total number of patients with AIDS who were alive as of July 1 annually as the AIDS population denominator, the average annual incidence of NHL was estimated among patients with AIDS for the pre‐HAART period (1988–1995) and post‐HAART period (1996–2000). The chi‐square test was used to compare proportions, and a Cox proportional hazards model was used to compare survival between the pre‐HAART and post‐HAART periods.RESULTSThe incidence of NHL decreased from 29.6 per 1000 person‐years pre‐HAART to 6.5 per 1000 person‐years post‐HAART. The proportion of patients who had NHL of central nervous system (CNS) origin decreased from 28% pre‐HAART to 17% post‐HAART. Among patients with systemic NHL, 54% received chemotherapy pre‐HAART, and 72% received chemotherapy post‐HAART. The percentage of intermediate‐grade NHL increased from 33% pre‐HAART to 49% post‐HAART, and the percentage of high‐grade NHL decreased from 38% to 19%, respectively. A diagnosis of human immunodeficiency virus infection preceding the NHL diagnosis and Stage IV NHL were associated with worse survival, whereas a diagnosis of NHL in the post‐HAART period and chemotherapy were associated with better survival. The median survival was 4 months pre‐HAART and 9 months post‐HAART.CONCLUSIONSSince the introduction of HAART, there has been a decrease in the incidence of systemic and CNS NHL among patients with AIDS. Among patients with systemic, AIDS‐related NHL, there has been decreased high‐grade histology, increased use of chemotherapy, and improved survival. Cancer 2006. © 2005 American Cancer Society.

The rising incidence of anal cancer among men with AIDS may be related to increased longevity with HAART and the consequent increased time at risk for the development of malignancy and/or the result of greater use of cytologic screening.

Post-conflict hospitalization rates of active duty Marines deployed to the Persian Gulf War were compared with hospitalization rates of similar Marine Corps units returning from the Vietnam conflict. The aggregated Gulf War units exhibited lower hospitalization rates than their Vietnam counterparts. Examined separately, infantry and service support units deployed to the Persian Gulf had lower postdeployment hospitalization rates than similar units returning from Vietnam; no significant rate differences existed for the combat engineer and artillery units. The Vietnam veterans had higher percentages of hospital admissions for infective and parasitic diseases and genitourinary disorders than Gulf War veterans, whereas Gulf War veterans had a higher proportion of their hospitalizations in the musculoskeletal disorder category. The types of individual musculoskeletal disorders incurred by the two cohorts were not substantially different.

SUMMARY ProblemAccounts of postdeployment health problems incurred by Gulf War veterans are many and varied.These accounts have reported a wide range of symptomatology, as well as put forth a large number of potential causes of the reported medical problems ObjectiveThe present study seeks to compare the post-conflict hospitalization rates of active duty personnel deployed to the Gulf War with the rates of personnel from similar units returning from the Vietnam Conflict, as well as to examine rate differences among the individual Gulf units. ApproachThe hospitalization incidence of Gulf War and Vietnam veterans was analyzed by contrasting the crude and age-adjusted admission rates for varying troop categories (infantry troops, artillery troops, combat engineers, and service support troops) in the five-year periods immediately following the two engagements. Hospital admissions of the combat veterans groups were also compared by their proportional distributions of disease categories. ResultsThere were no significant differences in hospitalization rates among the infantry, artillery, engineering, and service support units deployed to the Gulf War. Further, overall, and in four of the five postdeployment years, the aggregated Gulf War veterans exhibited lower hospitalization rates when compared with their Vietnam counterparts. In comparing hospital admission categories, differences existed between the Vietnam veterans and Gulf War veterans only in their proportions of'Infective and Parasitic' diseases, 'Genitourinary' disorders, and 'MusculoskeletaP disorders. ConclusionThe lack of differences in the hospitalization rates of various Gulf War units in differing locations on the battlefield provides no support to the notion that a specific environmental exposure is responsible for deleterious health effects on Gulf War veterans. That hospitalization rates of returning Gulf War veterans were either lower or comparable to the rates of veterans returning from a previous combat engagement also provides no support to the notion of an environmental exposure above and beyond that which might be associated with the demands of war itself.