Non-Hodgkin lymphoma in HIV-infected patients in the era of highly active antiretroviral therapy

Ole Kirk, Court Pedersen, Alessandro Cozzi-Lepri, Francisco Antunes, Veronica Miller, Jose M. Gatell, Christine Katlama, Adriano Lazzarin, Peter Skinhoj, Simon E. Barton

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Abstract

This study was designed to assess the influence of highly active antiretroviral therapy (HAART) on non-Hodgkin lymphoma (NHL) among patients infected with human immunodeficiency virus (HIV). Within EuroSIDA, a multicenter observational cohort of more than 8500 patients from across Europe, the incidences of NHL and subtypes (Burkitt, immunoblastic, primary brain lymphoma [PBL], and other/unknown histology) were determined according to calendar time of follow-up, and for those who initiated HAART (≥3 drugs) also time on HAART. Potential predictive factors of NHL were evaluated in Cox proportional hazard models. Over 26 764 person-years of prospective follow-up (PYF) from May 1994 to December 2000, the incidence of NHL decreased from 1.99 (95% confidence interval, 1.51-2.47) before September 1995 to 0.30 (0.19-0.42) cases/100 (PYF) after March 1999 (P <.001). The incidence of all subtypes of NHL decreased significantly and most pronouncedly for PBL. Among patients who started HAART, the incidence of NHL decreased from 0.88 (0.60-1.16) within the first 12 months after starting HAART to 0.45 (0.31-0.60) cases/100 PYF after more than 24 months (P = .004). In an adjusted Cox model for patients on HAART, the latest CD4 cell count and plasma viral load were both significantly associated with diagnosis of NHL; the relative hazard was 1.39 (range, 1.14-1.69) per 50% lower CD4 cell count, and 1.51 (range, 1.21-1.88) per 1 log higher plasma viral load. In conclusion, the incidence of NHL among HIV-infected patients has decreased significantly after the introduction of HAART, and the decline was most pronounced for PBL. After starting HAART, patients with insufficient immunologic and virologic responses were at highest risk of NHL.

Original languageEnglish
Pages (from-to)3406-3412
Number of pages7
JournalBlood
Volume98
Issue number12
DOIs
Publication statusPublished - Dec 1 2001

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Highly Active Antiretroviral Therapy
Viruses
Non-Hodgkin's Lymphoma
Brain
HIV
Hazards
Plasmas
Histology
Incidence
Lymphoma
CD4 Lymphocyte Count
Viral Load
Proportional Hazards Models
Pharmaceutical Preparations
Confidence Intervals

ASJC Scopus subject areas

  • Hematology

Cite this

Kirk, O., Pedersen, C., Cozzi-Lepri, A., Antunes, F., Miller, V., Gatell, J. M., ... Barton, S. E. (2001). Non-Hodgkin lymphoma in HIV-infected patients in the era of highly active antiretroviral therapy. Blood, 98(12), 3406-3412. https://doi.org/10.1182/blood.V98.12.3406

Non-Hodgkin lymphoma in HIV-infected patients in the era of highly active antiretroviral therapy. / Kirk, Ole; Pedersen, Court; Cozzi-Lepri, Alessandro; Antunes, Francisco; Miller, Veronica; Gatell, Jose M.; Katlama, Christine; Lazzarin, Adriano; Skinhoj, Peter; Barton, Simon E.

In: Blood, Vol. 98, No. 12, 01.12.2001, p. 3406-3412.

Research output: Contribution to journalArticle

Kirk, O, Pedersen, C, Cozzi-Lepri, A, Antunes, F, Miller, V, Gatell, JM, Katlama, C, Lazzarin, A, Skinhoj, P & Barton, SE 2001, 'Non-Hodgkin lymphoma in HIV-infected patients in the era of highly active antiretroviral therapy', Blood, vol. 98, no. 12, pp. 3406-3412. https://doi.org/10.1182/blood.V98.12.3406
Kirk O, Pedersen C, Cozzi-Lepri A, Antunes F, Miller V, Gatell JM et al. Non-Hodgkin lymphoma in HIV-infected patients in the era of highly active antiretroviral therapy. Blood. 2001 Dec 1;98(12):3406-3412. https://doi.org/10.1182/blood.V98.12.3406
Kirk, Ole ; Pedersen, Court ; Cozzi-Lepri, Alessandro ; Antunes, Francisco ; Miller, Veronica ; Gatell, Jose M. ; Katlama, Christine ; Lazzarin, Adriano ; Skinhoj, Peter ; Barton, Simon E. / Non-Hodgkin lymphoma in HIV-infected patients in the era of highly active antiretroviral therapy. In: Blood. 2001 ; Vol. 98, No. 12. pp. 3406-3412.
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abstract = "This study was designed to assess the influence of highly active antiretroviral therapy (HAART) on non-Hodgkin lymphoma (NHL) among patients infected with human immunodeficiency virus (HIV). Within EuroSIDA, a multicenter observational cohort of more than 8500 patients from across Europe, the incidences of NHL and subtypes (Burkitt, immunoblastic, primary brain lymphoma [PBL], and other/unknown histology) were determined according to calendar time of follow-up, and for those who initiated HAART (≥3 drugs) also time on HAART. Potential predictive factors of NHL were evaluated in Cox proportional hazard models. Over 26 764 person-years of prospective follow-up (PYF) from May 1994 to December 2000, the incidence of NHL decreased from 1.99 (95{\%} confidence interval, 1.51-2.47) before September 1995 to 0.30 (0.19-0.42) cases/100 (PYF) after March 1999 (P <.001). The incidence of all subtypes of NHL decreased significantly and most pronouncedly for PBL. Among patients who started HAART, the incidence of NHL decreased from 0.88 (0.60-1.16) within the first 12 months after starting HAART to 0.45 (0.31-0.60) cases/100 PYF after more than 24 months (P = .004). In an adjusted Cox model for patients on HAART, the latest CD4 cell count and plasma viral load were both significantly associated with diagnosis of NHL; the relative hazard was 1.39 (range, 1.14-1.69) per 50{\%} lower CD4 cell count, and 1.51 (range, 1.21-1.88) per 1 log higher plasma viral load. In conclusion, the incidence of NHL among HIV-infected patients has decreased significantly after the introduction of HAART, and the decline was most pronounced for PBL. After starting HAART, patients with insufficient immunologic and virologic responses were at highest risk of NHL.",
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