title: Clinical characteristics, incidence, and risk factors of HIV-related Hodgkin lymphoma in the era of combination antiretroviral therapy.
abstract: HIV-infected patients are at increased risk for developing HIV-related Hodgkin lymphoma (HIV-HL) despite the success of combination antiretroviral therapy (cART). To study the incidence of HIV-HL in HIV-patients with respect to the general population of Brescia, Italy, we conducted a single-center cohort study of HIV-patients followed from 1999 to 2009. The incidence of HIV-HL was compared to the incidence in the general population of Brescia using standardized incidence ratios (SIRs). Poisson analysis was used to study the association between covariates and HL. A total of 5085 HIV-patients were observed among 30,946 person-years; 30 patients developed HIV-HL. The incidence rate was 9.9 (95% confidence interval [CI], 6.7-14.1) per 10,000 person-years of follow-up. HL was substantially more frequent in HIV-patients than in the general population living in the same district area [standardized incidence rate, SIR=21.8 (95% CI, 15.33-31)]. The risk of HIV-HL tended to increase with lowering CD4+ cell counts at time of HL diagnosis [adjusted incidence relative risk (IRR) for CD4 cell count<50 cells/μL: 41.70, p<0.001]. HL risk had been elevated during the 6 months after combination antiretroviral therapy (cART) initiation (IRR: 26.65, p<0.001). Twenty-two HIV-HL cases were matched to 3280 controls. In the year preceding HIV-HL diagnosis the mean change in CD4+ cell counts between cases and controls was significantly different (-99 cells/μL for cases vs. +37 cells/μL for controls, p<0.0001). Compared with the general population, HIV-infected patients showed an increased risk for developing HL. The risk of HIV-HL increased significantly in the first months after cART initiation.
authors.affiliation: University Division of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy. daria.gotti@gmail.com
authors.forename: Daria
authors.initials: D
authors.lastname: Gotti
authors.forename: Marta
authors.initials: M
authors.lastname: Danesi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Calabresi
authors.forename: Alice
authors.initials: A
authors.lastname: Ferraresi
authors.forename: Laura
authors.initials: L
authors.lastname: Albini
authors.forename: Francesco
authors.initials: F
authors.lastname: Donato
authors.forename: Francesco
authors.initials: F
authors.lastname: Castelli
authors.forename: Alfredo
authors.initials: A
authors.lastname: Scalzini
authors.forename: Eugenia
authors.initials: E
authors.lastname: Quiros-Roldan
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000008:administration & dosage / Q000009:adverse effects*; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D016001:Confidence Intervals; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*; D015497:HIV-1; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D016483:Lymphoma, AIDS-Related / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D044966:Anti-Retroviral Agents