Advances in the epidemiology of HIV-associated non-Hodgkin's lymphoma and other lymphoid neoplasms.
The spectrum of HIV-related lymphoid malignancies certainly includes non-Hodgkin's lymphoma (NHL; i.e., chiefly large-cell lymphoma and Burkitt's lymphoma), primary lymphoma of the brain (PBL) and, possibly, Hodgkin's disease (HD). Since the mid-1990s, several epidemiological studies have led to better quantification of the burden of lymphomas in HIV-infected populations. AIDS surveillance data from 17 western European countries show that between 1988 and 1997 a total of 7,148 AIDS cases had NHL as the AIDS-defining illness. The yearly number of cases rose steadily from 1988 to 1995 but declined thereafter. As a percentage of AIDS-defining illnesses, NHL increased from 3.6% in 1994 to 4.9% in 1997. Percent increases were observed in different strata by area, age group, sex and HIV-transmission group. To estimate relative risk (RR) of NHL and other lymphoid neoplasms in unselected HIV-seropositive populations, records of population-based cancer registries and AIDS registries were linked in the United States, Italy and Australia. RRs for NHL in adults with HIV/AIDS ranged between 14 (for low-grade NHL) to over 300 (for high-grade NHL). For HD, the RR was approximately 10. Limited findings from studies based on death certificates and cohorts of HIV-seropositive persons were consistent with those from registry linkage studies. In developing countries, the risk of HIV-associated NHL appears to be much lower than in developed countries, but under-ascertainment and earlier death from other AIDS manifestations may explain the lack of HIV-associated lymphomas in Africa.
Franceschi
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S
Servizio di Epidemiologia, Centro di Riferimento Oncologico, Aviano, Italy. epidemiology@ets.it
Dal Maso
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La Vecchia
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C
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000328:Adult; D000349:Africa / Q000453:epidemiology; D001315:Australia / Q000453:epidemiology; D001932:Brain Neoplasms / Q000150:complications / Q000453:epidemiology*; D002648:Child; D005060:Europe / Q000453:epidemiology; D005260:Female; D006689:Hodgkin Disease / Q000150:complications / Q000453:epidemiology; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000150:complications / Q000453:epidemiology*; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000453:epidemiology*; D008297:Male; D012042:Registries; D018570:Risk Assessment; D014481:United States / Q000453:epidemiology