Factors associated with the occurrence of AIDS-related non-Hodgkin lymphoma in the era of highly active antiretroviral therapy: Aquitaine Cohort, France.
BACKGROUND
High grade non-Hodgkin lymphoma (NHL) remains the most common Acquired Immune Deficiency Syndrome (AIDS)-associated neoplasia and an important cause of mortality in people living with human immunodeficiency virus (HIV) infection in industrialized countries in the era of highly active antiretroviral therapy (HAART).


METHODS
A case-control study was implemented in a large cohort of HIV-infected patients. Case patients had newly diagnosed NHL, and control subjects were matched for CD4(+) cell count, calendar period, sex, and length of follow-up.


RESULTS
Variables associated with a decreased risk of NHL were the use of HAART during follow-up for at least 6 months (odds ratio [OR], 0.46; 95% confidence interval [CI], 0.21-0.98), receipt of a diagnosis of AIDS before the censoring date (OR, 0.37; 95% CI, 0.18-0.76), and undetectable level of HIV RNA during follow-up (OR, 0.34; 95% CI, 0.15-0.77). The use of antiherpetic drug for at least 6 months was associated with a nonsignificant decreased risk of NHL (OR, 0.40; 95% CI, 0.11-1.44; P=.16). In multivariate analysis, variables significantly associated with a decreased risk of NHL were the use of HAART for at least 6 months during follow-up (OR, 0.37; 95% CI, 0.16-0.87) and receipt of an AIDS-related diagnosis before the censoring date (OR, 0.44; 95% CI, 0.21-0.93). Age, transmission group, hepatitis B and C coinfections, CD4(+) and CD8(+) cell count nadir, and previous history of herpes virus infection were not associated with an increased risk for NHL.


CONCLUSIONS
The use of HAART for at least 6 months was associated with a decreased risk of NHL, whereas uncontrolled HIV RNA load may be associated with an increased risk. The role of antiherpetic drugs needs further investigation.
Bonnet
Fabrice
F
Service de Medecine Interne et Maladies Infectieuses, Hôpital Saint-André, Bordeaux, France. fabrice.bonnet@chu-bordeaux.fr
Balestre
Eric
E
Thiébaut
Rodolphe
R
Morlat
Philippe
P
Pellegrin
Jean-Luc
JL
Neau
Didier
D
Dabis
François
F
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D000998:Antiviral Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005602:France; D015497:HIV-1 / Q000378:metabolism; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000209:etiology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors; D012514:Sarcoma, Kaposi / Q000209:etiology
D000998:Antiviral Agents; D012367:RNA, Viral