Surveillance and clinical monitoring of aids-related malignancies in two u.s. military populations, 1986-1996

S8 Since October 1985, all military personnel on active duty, as well as applicants for military service, have undergone routine HIV testing. The databases resulting from this surveillance program have successfully been used to describe the epidemiology of HIV infection in military populations, through risk factor studies, epidemiological trend analyses and clinical outcomes research. One such database, the U.S. Army HIV Data System (USAHDS) maintains identifier-linked data files reflecting the dates and results of all HIV tests among active duty personnel. When linked to other military personnel and medical databases, USAHDS provides the ability to evaluate the type and extent of inpatient morbidity resulting from a wide array of illnesses. In addition to HIV surveillance databases, several clinically-based cohorts of HIV-infected military beneficiaries have been studied. One such cohort, the HIV Natural History Cohort of Military Beneficiaries, has been under investigation for over seven years in an effort to systematically document the natural history of HIV disease with clinical, laboratory and tissue sample data. In addition to clinical and laboratory data, information on antiretroviral treatment provided to subjects is routinely collected. As of March 1997, 3465 individuals have been enrolled in this multi-center study. Of these, 1854 (52%) are considered active, having been seen for a research visit at least once since 31 October 1995. Despite the inability of the surveillance databases to provide information on clinical and treatment characteristics of HIV-infected individuals, valuable information on the epidemiological trends in HIV-related neoplasms can successfully be obtained. Conversely, information from the clinical cohorts will provide important information on the association between the occurrence of neoplasms and highly active antiretroviral therapy. Data will be presented on the trends in neoplasm rates among HIV-infected and uninfected active duty military personnel. In addition, neoplasms rates in natural history, as well as clinical intervention trials will be presented.