Infectious complications in hiv patients and large b cell lymphoma at the instituto nacional de cancerologÿa, mexico

Abstract

BACKGROUND: The Diffuse Large B Cell Lymphoma (DLBCL) is the most common Non Hodgkin Lymphoma. The frequency and type of infections in patients with DLBCL and HIV, and the impact on the survival are still unknown. METHODS: We performed an observational, retrospective, longitudinal study in patients with DLBCL with and without HIV, that receive chemotherapy treatment from 2010-2019 at the Instituto Nacional de Cancerología, México. RESULTS: We analyzed 170 patients; 56 patients with HIV and 114 without HIV. We observed a predominance of male gender and advanced stage in both groups. During the first year of chemotherapy, 46% of patients without HIV and 70% with HIV, had an infectious complication. (p=0.0001). Gram-negative Enterobacteria predominated, with a pattern of sensibility pan sensible. In the bivariate analyses, hypoalbuminemia, high ECOG score, EPOCH chemotherapy and HIV positivity status were associated with the presence of infections. One episode of infection was associated with a decrease in Event free survival (EFS) (RR 2.14, p=0.007) and Overall Survival (OS) (RR 2.5, p=0.001), independently of the HIV status. In the multivariate analysis for OS, infections at diagnosis and Central Nervous System (CNS) infiltration were independent prognostic factors for survival. DISCUSSION: Patients with HIV infection and lymphoma have higher number of infections than patients without HIV, however HIV positivity status does not impact the survival of these patients. The functional and nutritional deterioration were associated with the development of infections in the entire cohort. Infections had an impact on EFS and OS, regardless of HIV status.