Friday, May 14, 2010

HIV-related non-Hodgkin lymphoma

Michael Carter for Aidsmap (May 13, 2010)

Higher CD4 cell count reduces risk of death from non-Hodgkin lymphoma for patients with HIV

Mortality rates are still higher amongst HIV-positive patients with non-Hodgkin lymphoma than in HIV-negative individuals with the cancer, US investigators report in the on-line edition of AIDS.

However, a higher CD4 cell count and the absence of previous AIDS-defining illnesses reduced the risk of death from the cancer for patients with HIV, a finding which the investigators believe argues for an “aggressive HIV disease management strategy for patients infected with HIV and potentially earlier start of combination antiretroviral therapy.”

Non-Hodgkin lymphoma is an AIDS-defining malignancy. The number of cases of the cancer seen in patients with HIV has fallen since the advent of effective HIV treatment. The prognosis of patients who are diagnosed with non-Hodgkin lymphoma has also improved, but the exact extent is uncertain.

Therefore investigators from Kaiser Permanente California conducted a population-based study, comparing all-cause and non-Hodgkin lymphoma-related mortality between HIV-positive and HIV-negative individuals diagnosed with the cancer. The period of analysis, 1996-2005, encompassed the era of combination antiretroviral therapy. The investigators also analyzed the factors associated with an increased risk of death for those with HIV.

They conclude that the study emphasizes “the importance in preserving the immune function during the course of HIV disease management, and further evaluating optimal treatment options for HIV-infected non-Hodgkin lymphoma patients with severely suppressed immunity, which account for 50% of the HIV-related non-Hodgkin lymphoma in the combination antiretroviral therapy era.”

Reference

Survival of non-Hodgkin lymphoma patients with and without HIV infection in the era of combined antiretroviral therapy.
Chao, Chun; Xu, Lanfang; Abrams, Donald; Leyden, Wendy; Horberg, Michael; Towner, William; Klein, Daniel; Tang, Beth; Silverberg, Michael
AIDS 24: online edition doi:10. 1097/QAD.0b013e32833a0961, 2010.

Link to AIDS abstract

Link to Aidsmap article

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