title: Childhood exposure to simian virus 40-contaminated poliovirus vaccine and risk of AIDS-associated non-Hodgkin's lymphoma.
abstract: Persons with acquired immunodeficiency syndrome (AIDS) have increased risk for non-Hodgkin's lymphoma (NHL). Recent studies have reported the detection of DNA sequences from simian virus 40 (SV40), a macaque polyomavirus that contaminated early poliovirus vaccines, in a large proportion of AIDS-associated NHLs. To examine the association between SV40 exposure and NHL risk, we analyzed data from a U.S. registry-based cohort study of persons with AIDS (1980-96). We calculated NHL incidence in persons born in 1958-61 (exposed to SV40-contaminated poliovirus vaccine as children, n = 39,468) and in 1964-67 (born after vaccines were cleared of SV40 and thus unexposed, n = 17,340). Among persons with AIDS, NHL incidence was 11.7 per 1,000 person-years in SV40-exposed individuals (616 NHL cases) and 10.1 per 1,000 person-years in SV40-unexposed individuals (230 cases; unadjusted relative risk 1.15, 95% CI 0.99-1.34, p = 0.06). Because of differences in cohorts' birth years and the evolving demographics of the AIDS epidemic, SV40-exposed subjects were older at AIDS onset than unexposed subjects (mean age 32.0 vs. 27.2 years, p < 0.0001), and the cohorts differed by sex (p < 0.0001) and ethnic group (p < 0.0001). Since NHL incidence was relatively high among whites (p < 0.0001) and homosexual males (p < 0.0001) and increased with age (p = 0.09), comparisons required adjustments for these factors. After adjustment, SV40 exposure was not associated with NHL incidence (adjusted relative risk 0.97, 95% CI 0.79-1.20, p = 0.80). We conclude that childhood exposure to SV40 through receipt of contaminated poliovirus vaccine was not associated with increased risk for AIDS-associated NHL. Our findings do not support a role for SV40 in lymphomagenesis among immunosuppressed persons.
authors.affiliation: Viral Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20892, USA. engelse@exchange.nih.gov
authors.forename: Eric A
authors.initials: EA
authors.lastname: Engels
authors.forename: Leonard H
authors.initials: LH
authors.lastname: Rodman
authors.forename: Morten
authors.initials: M
authors.lastname: Frisch
authors.forename: James J
authors.initials: JJ
authors.lastname: Goedert
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Biggar
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000952:Antigens, Polyomavirus Transforming / Q000235:genetics; D015331:Cohort Studies; D004279:DNA, Viral / Q000032:analysis; D004340:Drug Contamination; D005260:Female; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D016483:Lymphoma, AIDS-Related / Q000453:epidemiology* / Q000821:virology; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology* / Q000821:virology; D008297:Male; D023321:Poliovirus Vaccines / Q000008:administration & dosage*; D027601:Polyomavirus Infections / Q000453:epidemiology* / Q000821:virology; D015995:Prevalence; D012042:Registries; D012307:Risk Factors; D013539:Simian virus 40 / Q000502:physiology*; D014412:Tumor Virus Infections / Q000453:epidemiology* / Q000821:virology
chemical_list: D000952:Antigens, Polyomavirus Transforming; D004279:DNA, Viral; D023321:Poliovirus Vaccines