title: Evolution of HIV-Associated Lymphoma Over 3 Decades.
abstract: The emergence of combined antiretroviral therapy (cART) and improvements in the management of opportunistic infections have altered the HIV epidemic over the last 30 years. We aimed to assess changes to the biology and outcomes of HIV-associated lymphomas over this period at the national center for HIV oncology in the United Kingdom.
  
  
  
  Clinical characteristics at lymphoma diagnosis have been prospectively collected since 1986, along with details of lymphoma treatment and outcomes. The clinical features and outcomes were compared between 3 decades: pre-cART decade (1986-1995), early-cART decade (1996-2005), and late-cART decade (2006-2015).
  
  
  
  A total of 615 patients with HIV-associated lymphoma were included in the study: 158 patients in the pre-cART era, 200 patients in the early-cART era, and 257 patients in the late-cART era. In more recent decades, patients were older (P < 0.0001) and had higher CD4 cell counts (P < 0.0001) at lymphoma diagnosis. Over time, there has also been a shift in lymphoma histological subtypes, with an increase in lymphoma subtypes associated with moderate immunosuppression. The overall survival for patients with HIV-associated lymphoma has dramatically improved over the 3 decades (P < 0.0001).
  
  
  
  Over the last 30 years, the clinical demographic of HIV-associated lymphomas has evolved, and the outcomes have improved.
authors: *Department of Oncology, National Centre for HIV Malignancies, Chelsea and Westminster Hospital, London, United Kingdom; †School of Medicine, Imperial College London, London, United Kingdom; and ‡Department of HIV Medicine, National Centre for HIV Malignancies, Chelsea and Westminster Hospital, London, United Kingdom.
authors: Ramya
authors: R
authors: Ramaswami
authors: Germaine
authors: G
authors: Chia
authors: Alessia
authors: A
authors: Dalla Pria
authors: David J
authors: DJ
authors: Pinato
authors: Kizzy
authors: K
authors: Parker
authors: Mark
authors: M
authors: Nelson
authors: Mark
authors: M
authors: Bower
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D016483:Lymphoma, AIDS-Related / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult