Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor
In Reply: We did not analyze the effect of
therapy because of limited data. Most US children with AIDS were born between
1987 (when therapy first became available) and 1994, before the era of highly
active therapy. Thus, most children had the opportunity to receive antiretroviral
therapy of some type. However, AIDS registries are not reliable sources of
information about individual therapy.
Mr Gallagher and Dr Wang question our inclusion of brain lymphomas in
the analysis when these were reported only in the AIDS registry data. As explained
in our article, we were presented with an unusual finding in the analysis.
More than half (12) of the 23 cases of primary brain lymphoma recorded in
children were known only from the AIDS registry data. For 2 other cases, the
diagnosis was primary brain lymphoma in the AIDS registry but the cancer registry
information simply listed non-Hodgkin lymphoma. Among the remainder, 5 cases
were known from both AIDS and cancer registry data, and 4 cases were known
only from the cancer registry. Thus, had we restricted diagnoses of primary
brain lymphoma to the cancer registry data, we would have used only 39% of
the reported cases. In contrast, among children with AIDS who had known nonbrain
lymphomas, 71% of cases were found in the cancer registries, a proportion
similar to that found in adults with AIDS.
Biggar RJ, Frisch M. Estimating the Risk of Cancer in Children With AIDS—Reply. JAMA. 2000;284(20):2593-2594. doi:10.1001/jama.284.20.2591