Non-Hodgkin lymphoma risk in adults living with HIV across five continents: a multicohort study.

Rohner, Eliane; Bütikofer, Lukas; Schmidlin, Kurt; Sengayi, Mazvita; Maskew, Mhairi; Giddy, Janet; Moore, Richard D; Goedert, James J; Gill, John M; Silverberg, Michael J; Patel, Pragna; Castilho, Jessica; Hoy, Jennifer; Sohn, Annette; Bani-Sadr, Firouze; Taylor, Ninon; Paparizos, Vassilios; Le Moing, Vincent; Bonnet, Fabrice; Verbon, Annelies; ... (2018). Non-Hodgkin lymphoma risk in adults living with HIV across five continents: a multicohort study. AIDS, 32(18), pp. 2777-2786. Lippincott Williams & Wilkins 10.1097/QAD.0000000000002003

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OBJECTIVE To compare non-Hodgkin lymphoma (NHL) incidence rates in adults who started antiretroviral therapy (ART) across the Asia-Pacific, South Africa, Europe, Latin, and North America. METHODS We included cohort data of adults living with HIV who started ART after 1995 within the framework of the International epidemiology Databases to Evaluate AIDS (IeDEA) and the Collaboration of Observational HIV Epidemiological Research in Europe (COHERE). We used flexible parametric survival models to compare regional NHL rates at 2 years after ART start and to identify risk factors for NHL. RESULTS We included 210,898 adults with 1.1 million person-years (pys) of follow-up and 1,552 incident NHL cases (raw overall incidence rate 142/100,000 pys). After adjusting for age at ART start, first-line ART regimen, calendar period of ART start, and especially current CD4 cell count, NHL rates were similar across regions for most population groups. However, South African women remained at increased risk of developing NHL compared with their European counterparts (adjusted hazard ratio [aHR] 1.79, 95% CI 1.19-2.70). In Europe, Latin and North America, NHL risk was highest in men who have sex with men (MSM, aHR 1.30, 95% CI 1.14-1.48), followed by heterosexual men (referent), and women (aHR 0.66, 95% CI 0.57-0.78). CONCLUSIONS The risk of developing NHL is higher in women in South Africa than in Europe and higher in MSM compared with heterosexual men and women. Reasons for these differences remain unclear. Early ART access and regular patient monitoring to avert low CD4 cell counts remain key for NHL prevention.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern

UniBE Contributor:

Rohner, Eliane; Bütikofer, Lukas; Schmidlin, Kurt; Egger, Matthias and Bohlius, Julia

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0269-9370

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Tanya Karrer

Date Deposited:

01 Oct 2018 09:04

Last Modified:

15 Nov 2018 17:12

Publisher DOI:

10.1097/QAD.0000000000002003

PubMed ID:

30234606

BORIS DOI:

10.7892/boris.120144

URI:

https://boris.unibe.ch/id/eprint/120144

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