title: Viral co-infections and paraproteins in HIV: effect on development of hematological malignancies.
abstract: The role of viral co-infections and paraproteins in the development of hematological malignancies (HMs) in HIV remains unclear. Using our large database of HIV+ patients, we investigated whether co-infection and paraproteinemia increase the risk of HM. Data on demographics, hepatitis B (HBV) and hepatitis C virus (HCV) co-infections, paraproteinemia, HIV characteristics, and biopsy proven malignant hematological disorders for HIV+ patients were collected over a 10-year period in a large urban hospital setting. We identified 10,293 HIV+ patients who were followed for a median duration of 53 months. Of the 10,293 patients with HIV, 229 (2.2 %) were diagnosed with a HM. Over 85 % of patients in both groups were tested; no significant difference in the prevalence of chronic HBV or HCV was noted between the HM positive (n = 229) and HM negative (n = 9992) patients. The serum protein electrophoresis test was performed for 1371 of the 10,221 patients. HM positive patients, compared to HM negative, were more likely to be tested for paraproteins (OR 3.3, 95 % CI 2.5-4.4) and more likely to have a discrete paraprotein band (OR 3.3, 95 % CI 1.2-8.9). Discrete paraproteins exclusively correlated with the development of plasma cell malignancies. Faint or oligoclonal protein bands were seen in high grade B cell lymphomas but did not show a significant correlation with HM development. Chronic hepatitis B or C infections did not correlate with the development of HM in HIV; however, viral influence on host gene transformation may have been impacted by anti-viral therapy limiting the duration of high viremic states.
authors.affiliation: Division of Hematology, Department of Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Erin
authors.initials: E
authors.lastname: Jou
authors.affiliation: Division of Hematology, Department of Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Oleg
authors.initials: O
authors.lastname: Gligich
authors.affiliation: Partner State Key Laboratory of Oncology in South China, Sir Y K Pao Centre for Cancer, Department of Clinical Oncology, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong.
authors.forename: Alvita C Y
authors.initials: AC
authors.lastname: Chan
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Diwakar
authors.initials: D
authors.lastname: Mohan
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Uriel R
authors.initials: UR
authors.lastname: Felsen
authors.affiliation: Department of Hematology and Oncology, University Hospitals Case Medical Center, Cleveland, OH, USA.
authors.forename: Sabarish
authors.initials: S
authors.lastname: Ayyappan
authors.affiliation: Division of Hematology, Department of Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Henny H
authors.initials: HH
authors.lastname: Billett
authors.affiliation: Partner State Key Laboratory of Oncology in South China, Sir Y K Pao Centre for Cancer, Department of Clinical Oncology, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong.
authors.forename: Edwin P
authors.initials: EP
authors.lastname: Hui
authors.affiliation: Partner State Key Laboratory of Oncology in South China, Sir Y K Pao Centre for Cancer, Department of Clinical Oncology, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong.
authors.forename: Anthony T C
authors.initials: AT
authors.lastname: Chan
authors.affiliation: Partner State Key Laboratory of Oncology in South China, Sir Y K Pao Centre for Cancer, Department of Clinical Oncology, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong. rradha80@gmail.com.
authors.forename: Radha
authors.initials: R
authors.lastname: Raghupathy
mesh_terms: D000328:Adult; D015331:Cohort Studies; D060085:Coinfection / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D019337:Hematologic Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D006509:Hepatitis B / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D006526:Hepatitis C / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010266:Paraproteins / Q000378:metabolism*
chemical_list: D010266:Paraproteins
keywords: HIV; Hematological malignancy; Hepatitis B; Hepatitis C; Paraproteinemia