NDLI: Immunologic and virologic predictors of AIDS-related non-hodgkin lymphoma in the highly active antiretroviral therapy era.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Engels, Eric A. Pfeiffer, Ruth M. Landgren, Ola Moore, Richard D.
Description	Author Affiliation: Engels EA ( Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, DHHS, 6120 Executive Boulevard, EPS 7076 Rockville, MD 20892. engelse@exchange.nih.gov)
Abstract	HIV-infected persons treated with highly active antiretroviral therapy (HAART) continue to have elevated risk for non-Hodgkin lymphoma (NHL). We conducted a retrospective cohort study of NHL among patients at an urban HIV clinic (N = 3025). Proportional hazards models identified immunologic and virologic predictors of NHL. Sixty-five NHLs arose during 1989 to 2006. NHL incidence declined over time. Nonetheless, 51 NHLs (78%) occurred within the HAART era (1996-2006). NHL risk increased with declining CD4 count (P trend < 0.0001) and increasing HIV viral load (P trend = 0.005). In a multivariable model, NHL risk was independently associated with both current CD4 count (hazard ratios 7.7 and 3.8, respectively, for CD4 counts 0-99 and 100-249 vs. 250+ cells/mm(3); P trend < 0.0001) and prior time spent with a viral load above 5.00 log(10) copies/mL (hazard ratios of 3.4, 2.6, and 6.8, respectively, for 0.1-0.4, 0.5-1.4, and 1.5+ yr vs. 0 yr; P trend = 0.004). Although serum globulin levels were elevated compared with the general population, NHL risk was unrelated to this B-cell activation marker (P = 0.39). Among HIV-infected individuals in the HAART era, NHLs are linked to immunosuppression and extended periods of uncontrolled HIV viremia. The association with high-level viremia could reflect detrimental effects on immune function related to incompletely effective HAART or direct effects on B cells.
File Format	HTM / HTML
ISSN	15254135
e-ISSN	10779450
DOI	10.1097/01.qai.0000371677.48743.8d
Journal	JAIDS Journal of Acquired Immune Deficiency Syndromes
Issue Number	1
Volume Number	54
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2010-05-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline AIDS Acquired Immunodeficiency Syndrome Immunology Virology Antiretroviral Therapy, Highly Active Lymphoma, Aids-related Diagnosis Lymphoma, Non-hodgkin Drug Therapy Adolescent Cd4 Lymphocyte Count Cohort Studies Retrospective Studies Risk Factors Viral Load Research Support, N.i.h., Extramural Research Support, N.i.h., Intramural
Content Type	Text
Resource Type	Article
Subject	Infectious Diseases Pharmacology (medical)

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