Increase in Hodgkin’s Lymphoma in HAART Era
Among people living with AIDS, the frequency of Hodgkin’s lymphoma has increased since the introduction of highly active antiretroviral therapy (HAART). These results were published in the journal Blood.
People living with AIDS (acquired immunodeficiency syndrome) have an increased risk of developing certain types of cancer, such as Kaposi sarcoma, non-Hodgkin’s lymphoma, and cervical cancer. Risk of Hodgkin’s lymphoma is also increased, and the frequency of Hodgkin’s lymphoma in people living with AIDS appears to have increased in recent years.
To explore patterns in Hodgkin’s lymphoma over time and by CD4 T-lymphocyte count, researchers conducted a study among more than 300,000 people who were diagnosed with AIDS between 1980 and 2002.
- Overall, the risk of Hodgkin’s lymphoma was more than nine times higher among study participants than among the general population.
- The frequency of Hodgkin’s lymphoma among study participants increased from roughly 31 per 100,000 people per year before 1996 (the pre-HAART era) to 49 per 100,000 people per year after 1996 (the HAART era).
- In contrast to non-Hodgkin’s lymphoma, which was most common among those with the lowest CD4 counts, Hodgkin’s lymphoma was most common among those with higher CD4 counts. The frequency of Hodgkin’s lymphoma was 56 per 100,000 people per year among those with a CD4 count between 225 and 249, and 20 per 100,000 people per year among those with a CD4 count less than 25.
The researchers conclude that the Hodgkin’s lymphoma is more common among individuals with moderate immune suppression than among individuals with more severe immune suppression. HAART-related improvements in CD4 counts likely explain the increase in Hodgkin’s lymphoma that occurred after 1996 in people living with AIDS.
While the increase in Hodgkin’s lymphoma among people living with AIDS is a cause for concern, it should be noted that the frequency of non-Hodgkin’s lymphoma and Kaposi sarcoma-the two most common AIDS-associated cancers-has decreased since the introduction of HAART.
Reference: Biggar RJ, Jaffe ES, Goedert JJ, Chaturvedi A, Pfeiffer R, Engels EA. Hodgkin Lymphoma and Immunodeficiency in Persons with HIV/AIDS. Blood. 2006;108:3786-3791.