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Hodgkin lymphoma is as common as non‐ H odgkin lymphoma in HIV ‐positive patients with sustained viral suppression and limited immune deficiency: a prospective cohort study
Author(s) -
Hoffmann C,
Hentrich M,
Gillor D,
Behrens G,
Jensen B,
Stoehr A,
Esser S,
Lunzen J,
Krznaric I,
Müller M,
Oette M,
Hensel M,
Thoden J,
Fätkenheuer G,
Wyen C
Publication year - 2015
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12200
Subject(s) - medicine , lymphoma , prospective cohort study , viral load , incidence (geometry) , cohort , non hodgkin's lymphoma , gastroenterology , hodgkin lymphoma , human immunodeficiency virus (hiv) , immunology , physics , optics
Objectives The incidence of HIV ‐related non‐ H odgkin lymphoma ( NHL ) but not that of H odgkin lymphoma ( HL ) has been declining. The aim of the study was to compare HIV ‐infected patients with NHL and HL with respect to antiretroviral therapy ( ART ) exposure at the time of lymphoma diagnosis. Methods HIV ‐infected patients with NHL and HL included in a prospective multicentre cohort study since J anuary 2005 were compared with respect to ART exposure and viral load at the time of lymphoma diagnosis. Results As of 31 D ecember 2012, data for 329 patients with NHL and 86 patients with HL from 31 participating centres were available. Patients with HL were more likely to be on ART (73.5% vs. 39.1%, respectively; P < 0.001) and more frequently had a viral load below the detection limit (57.3% vs. 27.9%, respectively; P < 0.001) than patients with NHL . The proportion of patients with HL was 8.0% in ART ‐naïve patients, 34.8% in patients with current HIV RNA < 50 HIV ‐1 RNA copies/mL, and 50.0% in patients with both HIV RNA < 50 copies/mL for > 12 months and a CD 4 cell count of > 200 cells/μL. Of note, 45.8% of all patients with NHL were not currently on ART and had a CD 4 count of < 350 cells/μL. Conclusions This prospective cohort study shows that HL was as common as NHL in patients with sustained viral suppression and limited immune deficiency. In contrast to NHL , the majority of patients with HL were on effective ART , suggesting that ART provides insufficient protection from developing HL . The high proportion of untreated patients with NHL suggests missed opportunities for earlier initiation of ART .