Journal Article

Factors Associated with the Occurrence of AIDS-Related Non-Hodgkin Lymphoma in the Era of Highly Active Antiretroviral Therapy: Aquitaine Cohort, France

Fabrice Bonnet, Eric Balestre, Rodolphe Thiébaut, Philippe Morlat, Jean-Luc Pellegrin, Didier Neau and François Dabis

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 42, issue 3, pages 411-417
Published in print February 2006 | ISSN: 1058-4838
Published online February 2006 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/499054
Factors Associated with the Occurrence of AIDS-Related Non-Hodgkin Lymphoma in the Era of Highly Active Antiretroviral Therapy: Aquitaine Cohort, France

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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).

Method. 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.

Conclusion. 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.

Journal Article.  4599 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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