Haematologica (Jun 2009)

CD4 counts and the risk of systemic non-Hodgkin’s lymphoma in individuals with HIV in the UK

  • 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,
  • for the UK CHIC Steering Committee

DOI
https://doi.org/10.3324/haematol.2008.002691
Journal volume & issue
Vol. 94, no. 6

Abstract

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Since the introduction of highly active antiretroviral therapy, there has been a decline in the incidence of non-Hodgkin’s lymphoma among HIV-infected individuals. We described trends in the incidence of systemic non-Hodgkin’s lymphoma in the UK CHIC Study from 1996–2006 and evaluated the association between immunosuppression and development of systemic non-Hodgkin’s lymphoma: 286/23,155 (1.2%) individuals developed an AIDS-defining lymphoma (258 systemic). Younger age, receipt of highly active antiretroviral therapy and later calendar year were all independently associated with a reduced risk of systemic non-Hodgkin’s lymphoma. A lower latest CD4 count was strongly associated with systemic non-Hodgkin’s lymphoma, in patients who had (RR per log2(cells/mm3) higher: 0.62) and had not (0.70) received highly active antiretroviral therapy. Associations with other measures of immunosuppression, including nadir CD4 count, experience and duration of severe immunosuppression, were generally weaker. Earlier highly active anti-retroviral therapy initiation and wider access to HIV testing is advocated to reduce the risk of systemic non-Hodgkin’s lymphoma.