Risk of non-Hodgkin lymphoma subtypes in HIV-infected people during the HAART era: a population-based study

Details

• Alternative Title:
  AIDS
• Personal Author:
  Gibson, Todd M. ; Morton, Lindsay M. ; Shiels, Meredith S. ; Clarke, Christina A. ; Engels, Eric A.
• Description:
  Objective
  
  HIV-infected people have greatly elevated risk of non-Hodgkin lymphoma (NHL), particularly the AIDS-defining NHL subtypes: diffuse large B-cell lymphoma, Burkitt lymphoma and primary lymphomas arising in the central nervous system. The goals of this analysis were to comprehensively describe risks of NHL subtypes, especially those not well studied, among HIV/AIDS patients; examine risks specifically in the HAART era; and distinguish risks in HIV-infected individuals prior to diagnosis with AIDS.
  
  Design
  
  Population-based registry linkage study.
  
  Methods
  
  We used data from the US HIV/AIDS Cancer Match Study from 1996 to 2010 (N = 273 705) to calculate standardized incidence ratios (SIRs) comparing subtype specific NHL risks in HIV-infected people to those in the general population, and used Poisson regression to test for differences in SIRs between the HIV-only and AIDS periods.
  
  Results
  
  NHL risk was elevated 11-fold compared to the general population, but varied substantially by subtype. AIDS-defining NHL subtypes comprised the majority, and risks were high (SIRs ≥ 17), but risks were also increased for some T-cell lymphomas (SIRs = 3.6–14.2), marginal zone lymphoma (SIR = 2.4), lymphoplasmacytic lymphoma/Waldenström macroglobulinemia (SIR = 3.6), and acute lymphoblastic leuke mia/lymphoma (SIR = 2.4).
  
  Conclusion
  
  HIV-infected people in the HAART era continue to have elevated risk of AIDS-defining NHL subtypes, highlighting the contribution of moderate and severe immunosuppression to their cause. Whereas non-AIDS-defining subtypes are much less common, immunosuppression or other dysregulated immune states likely play a role in the cause of some T-cell lymphomas, marginal zone lymphoma, lymphoplasmacytic lymphoma/Waldenström macroglobulinemia, and acute lymphoblastic leukemia/lym phoma.
  
  
• Subjects:
  Antiretroviral Therapy, Highly Active Article HIV Infections Humans Incidence Lymphoma, Non-Hodgkin Risk Assessment
• Source:
  AIDS. 2014; 28(15):2313-2318.
• Pubmed ID:
  25111081
• Pubmed Central ID:
  PMC4260326
• Document Type:
  Journal Article
• Funding:
  5U58DP000812-03/DP/NCCDPHP CDC HHS/United States ; 5U58DP000824-04/DP/NCCDPHP CDC HHS/United States ; 5U58DP003875-01/DP/NCCDPHP CDC HHS/United States ; 5U58DP003931-02/DP/NCCDPHP CDC HHS/United States ; HHSN261201000024C/PHS HHS/United States ; HHSN261201300021I/PHS HHS/United States ; N01PC-2013-00021/PC/NCI NIH HHS/United States ; U58 DP000848-04/DP/NCCDPHP CDC HHS/United States ; Z99 CA999999/Intramural NIH HHS/United States
• Place as Subject:
  United States
• Volume:
  28
• Issue:
  15
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:a9c6b7970550957508056c0a2159d4eca5af6cae0fd609cbc0e86b03e39d3ae6
• Download URL:
  https://stacks.cdc.gov/view/cdc/30199/cdc_30199_DS1.pdf
• File Type:
  [PDF - 142.22 KB ]