|
|
Abstract
NON-HODGKIN LYMPHOMA (NHL) AMONG HIV-INFECTED PATIENTS IN THE ERA OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART)
KIRK O, MOCROFT A, BARTON S, PEDERSEN C, SKINHØJ P, MILLER V, LUNDGREN J
Object: To analyse the influence of HAART on the risk of NHL among HIV-infected patients.
Material/methods: Within EuroSIDA, a prospective multi-centre observational cohort following more than 8500 patients from across Europe, the incidences of NHL and subtypes (Burkitt, immunoblastic, primary brain lymphoma (PBL) and other/unknown histology) were assessed according to calendar time of follow-up, latest CD4 level and for those who initiated HAART (>=3 drugs) also time on HAART. Prospective follow-up from May 1994 to July 2000 was included in the analysis.
Results: Within 23,751 person-years of follow-up, the incidence of NHL decreased from 1.99 (95%-CI: 1.52 –2.47) before September 1995 to 0.42 (0.27-0.61) cases/100 person-years of follow-up (PYF) after March 1999; p<0.001. The incidence of all subtypes of NHL decreased significantly, and the decline was most pronounced for PBL (incidence rate ratio: 0.06 (0.02-0.20); p<0.001). At severe immune depression (latest CD4<50 cells/mm3), the initiation of HAART was associated with a lower risk of NHL (incidence of 3.53 (2.22-4.84) cases/100 PYF among patients who initiated HAART versus 7.69 (5.99-9.38) among those who had not started HAART; p<0.001). In contrast, at a latest CD4 count>200 cell/mm3 there was no difference according to whether HAART had been initiated (HAART: 0.33 (0.17-0.51) versus no HAART: 0.31 (0.15-0.47); p=0.86). Among patients who started HAART, the incidence of NHL decreased from 0.90 (0.61-1.20) within the first 12 months after starting HAART to 0.51 (0.33-0.70) after more than 24 months; p<0.001.
Conclusions: We have documented a significant decrease of NHL from 1994 to 2000, and a decreasing incidence of NHL after initiation of HAART. The decline was most pronounced for primary brain lymphoma and primarily among patients with severe immune deficiency.
The 1st. IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
69
Suggested Citation
"KIRKO, et al.
NON-HODGKIN LYMPHOMA (NHL) AMONG HIV-INFECTED PATIENTS IN THE ERA OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART).
Oral Presentation:
The 1st. IAS Conference on HIV Pathogenesis and Treatment
:
Abstract no.
69"
|
|
|