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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
HIV viremia and incidence of non-Hodgkin lymphoma in patients successfully treated with antiretroviral therapy
Clinical Infectious Diseases, Volume 58, No. 11, Year 2014
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Description
Background. The incidence of non-Hodgkin lymphoma (NHL) in human immunodeficiency virus (HIV)-infected patients remains high despite treatment with antiretroviral therapy (ART). Methods. We evaluated NHL incidence in HIV-infected patients followed in the Centers for AIDS Research Network of Integrated Clinical Systems who started combination ART and achieved suppression of HIV. We estimated the hazard ratio for NHL by time-varying HIV viremia categories, accounting for time-varying CD4 cell count using marginal structural models. Results. We observed 37 incident NHL diagnoses during 21 607 person-years of follow-up in 6036 patients (incidence rate, 171 per 100 000 person-years; 95% confidence interval [CI], 124-236). NHL incidence was high even among patients with nadir CD4 cell count >200 cells/μL (140 per 100 000 person-years [95% CI, 80-247]). Compared with ≤50 copies/mL, hazard ratios (HRs) for NHL were higher among those with HIV viremia of 51-500 copies/mL (HR current = 1.66 [95% CI, .70-3.94]; HR 3-month lagged = 2.10 [95% CI, .84-5.22]; and HR 6-month lagged = 1.46 [95% CI, .60-3.60]) and >500 copies/mL (HR current = 2.39 [95% CI, .92-6.21]; HR 3-month lagged = 3.56 [95% CI, 1.21-10.49]; and HR 6-month lagged = 2.50 [95% CI, .91-6.84]). Current HIV RNA as a continuous variable was also associated with NHL (HR = 1.42 per log10 copies/mL [95% CI, 1.05-1.92]). Conclusions. Our findings demonstrate a high incidence of NHL among HIV-infected patients on ART and suggest a role of HIV viremia in the pathogenesis of NHL. Earlier initiation of potent ART and maximal continuous suppression of HIV viremia may further reduce NHL risk. © The Author 2014.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC4017888/bin/supp_58_11_1599__index.html
https://efashare.b-cdn.net/share/pmc/articles/PMC4017888/bin/supp_ciu076_ciu076supp_table1.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC4017888/bin/supp_ciu076_ciu076supp_table2.docx
Authors & Co-Authors
Achenbach, Chad J.
United States, Evanston
Northwestern University
Buchanan, Ashley L.
United States, Chapel Hill
Gillings School of Global Public Health
Cole, Stephen R.
United States, Chapel Hill
Gillings School of Global Public Health
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Hou, Lifang
United States, Evanston
Northwestern University
Mugavero, Michael J.
United States, Birmingham
The University of Alabama at Birmingham
Crane, Heidi M.
United States, Seattle
University of Washington
Moore, Richard D.
United States, Baltimore
Johns Hopkins School of Medicine
Haubrich, Richard H.
United States, La Jolla
University of California, San Diego
Gopal, Satish
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Eron, Joseph J.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Hunt, Peter W.
United States, San Francisco
University of California, San Francisco
Rodriguez, Benigno A.
United States, Cleveland
Case Western Reserve University
Mayer, Kenneth H.
United States, Boston
Harvard Medical School
Saag, Michael S.
United States, Birmingham
The University of Alabama at Birmingham
Kitahata, Mari M.
United States, Seattle
University of Washington
Statistics
Citations: 39
Authors: 15
Affiliations: 10
Identifiers
Doi:
10.1093/cid/ciu076
ISSN:
10584838
Research Areas
Environmental
Infectious Diseases
Study Design
Cohort Study