PURPOSE: Immunosuppression induced by HIV-1 increases the risk of developing non-Hodgkin's lymphoma (NHL). We measured the influence of immunologic factors and highly active antiretroviral therapy (HAART) on this risk. As there are no data demonstrating that specific antiretroviral regimens are effective at protecting from NHL, we compared different HAART regimens. PATIENTS AND METHODS: The protective effect of HAART regimens, containing protease inhibitors (PI) and/or non-nucleoside reverse transcriptase inhibitors (NNRTIs) on the development of NHL was examined in a prospectively recorded cohort of 9,621 HIV-infected individuals. Lymphocyte and natural killer subset data were also entered in univariate and multivariate analyses to establish and stratify the risk of NHL. RESULTS: From this cohort of 9,621 patients, 102 have been diagnosed with systemic AIDS-related NHL since 1996, when HAART became freely available here. By univariate analysis, increased age, higher nadir CD4 and CD8 T-cell counts, CD19 B-cell count, CD16/56 natural killer count and exposure to NNRTI or PI containing HAART conferred significant protection against NHL (P <.05). In a multivariate analysis, age, nadir CD4 and CD8 T-cell counts, and exposure to HAART were independent predictors of risk of NHL (P <.02). NNRTI-based HAART (adjusted rate ratio, 0.4; 95% CI, 0.3 to 0.5) was as protective as PI-based HAART, and these were significantly more protective than nucleoside analogues alone (rate ratio, 0.5; 95% CI, 0.4 to 0.7) or no antiretrovirals (P <.001). CONCLUSION: Effective HAART-induced maintenance of CD4 and CD8 counts protects from systemic AIDS-related NHL.
PURPOSE: Immunosuppression induced by HIV-1 increases the risk of developing non-Hodgkin's lymphoma (NHL). We measured the influence of immunologic factors and highly active antiretroviral therapy (HAART) on this risk. As there are no data demonstrating that specific antiretroviral regimens are effective at protecting from NHL, we compared different HAART regimens. PATIENTS AND METHODS: The protective effect of HAART regimens, containing protease inhibitors (PI) and/or non-nucleoside reverse transcriptase inhibitors (NNRTIs) on the development of NHL was examined in a prospectively recorded cohort of 9,621 HIV-infected individuals. Lymphocyte and natural killer subset data were also entered in univariate and multivariate analyses to establish and stratify the risk of NHL. RESULTS: From this cohort of 9,621 patients, 102 have been diagnosed with systemic AIDS-related NHL since 1996, when HAART became freely available here. By univariate analysis, increased age, higher nadir CD4 and CD8 T-cell counts, CD19 B-cell count, CD16/56 natural killer count and exposure to NNRTI or PI containing HAART conferred significant protection against NHL (P <.05). In a multivariate analysis, age, nadir CD4 and CD8 T-cell counts, and exposure to HAART were independent predictors of risk of NHL (P <.02). NNRTI-based HAART (adjusted rate ratio, 0.4; 95% CI, 0.3 to 0.5) was as protective as PI-based HAART, and these were significantly more protective than nucleoside analogues alone (rate ratio, 0.5; 95% CI, 0.4 to 0.7) or no antiretrovirals (P <.001). CONCLUSION: Effective HAART-induced maintenance of CD4 and CD8 counts protects from systemic AIDS-related NHL.
Authors: C L Davies; R Chinn; M Nelson; M Rasanesan; B Gazzard; T Powles; M Bower; J Stebbing Journal: AJNR Am J Neuroradiol Date: 2007-09-26 Impact factor: 3.825
Authors: Nancy Crum-Cianflone; Katherine Huppler Hullsiek; Vincent Marconi; Amy Weintrob; Anuradha Ganesan; R Vincent Barthel; Susan Fraser; Brian K Agan; Scott Wegner Journal: AIDS Date: 2009-01-02 Impact factor: 4.177
Authors: K Petoumenos; M T van Leuwen; C M Vajdic; I Woolley; J Chuah; D J Templeton; A E Grulich; M G Law Journal: HIV Med Date: 2012-08-30 Impact factor: 3.180
Authors: Mark Bower; Martin Fisher; Teresa Hill; Iain Reeves; John Walsh; Chloe Orkin; Andrew N Phillips; Loveleen Bansi; Richard Gilson; Philippa Easterbrook; Margaret Johnson; Brian Gazzard; Clifford Leen; Deenan Pillay; Achim Schwenk; Jane Anderson; Kholoud Porter; Mark Gompels; Caroline A Sabin Journal: Haematologica Date: 2009-03-31 Impact factor: 9.941
Authors: Julia Bohlius; Kurt Schmidlin; Dominique Costagliola; Gerd Fätkenheuer; Margaret May; Anna Maria Caro-Murillo; Amanda Mocroft; Fabrice Bonnet; Gary Clifford; Anastasia Karafoulidou; Jose M Miro; Jens Lundgren; Genevieve Chene; Matthias Egger Journal: Antivir Ther Date: 2009