title: HIV-associated Hodgkin lymphoma during the first months on combination antiretroviral therapy.
abstract: Hodgkin lymphoma (HL) incidence with HIV infection may have increased with the introduction of combination antiretroviral therapy (cART), suggesting that immune reconstitution may contribute to some cases. We evaluated HL risk with cART during the first months of treatment. With 187 HL cases among 64 368 HIV patients in France, relative rates (RRs) and 95% confidence intervals (CIs) of HL were estimated using Poisson models for duration of cART, CD4 count, and HIV load, with and without adjustment for demographic/clinical covariates. HL risk was unrelated to cART use overall, but it was related to time intervals after cART initiation (P = .006). Risk was especially and significantly elevated in months 1-3 on cART (RR 2.95, CI 1.64-5.31), lower in months 4-6 (RR 1.63), and null with longer use (RR 1.00). CD4 count was strongly associated with HL risk (P < 10⁻⁶), with the highest HL incidence at 50-99 CD4 cells/mm³. With adjustment for CD4 count and covariates, HL risk was elevated, but not significantly (RR 1.42), in months 1-3 on cART. HIV load had no added effect. HL risk increased significantly soon after cART initiation, which was largely explained by the CD4 count. Further studies of HIV-associated HL are needed.
authors.affiliation: Inserm, Paris, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Lanoy
authors.forename: Philip S
authors.initials: PS
authors.lastname: Rosenberg
authors.forename: Fabien
authors.initials: F
authors.lastname: Fily
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Lascaux
authors.forename: Valerie
authors.initials: V
authors.lastname: Martinez
authors.forename: Maria
authors.initials: M
authors.lastname: Partisani
authors.forename: Isabelle
authors.initials: I
authors.lastname: Poizot-Martin
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Rouveix
authors.forename: Eric A
authors.initials: EA
authors.lastname: Engels
authors.forename: Dominique
authors.initials: D
authors.lastname: Costagliola
authors.forename: James J
authors.initials: JJ
authors.lastname: Goedert
mesh_terms: D000293:Adolescent; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count / Q000706:statistics & numerical data; D016208:Databases, Factual / Q000706:statistics & numerical data; D004359:Drug Therapy, Combination; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology*; D006689:Hodgkin Disease / Q000453:epidemiology* / Q000821:virology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D016012:Poisson Distribution; D012307:Risk Factors; D019562:Viral Load / Q000706:statistics & numerical data
chemical_list: D044966:Anti-Retroviral Agents