Bower Mark, Fisher Martin, Hill Teresa, Reeves Iain, Walsh John, Orkin Chloe, Phillips Andrew N, Bansi Loveleen, Gilson Richard, Easterbrook Philippa, Johnson Margaret, Gazzard Brian, Leen Clifford, Pillay Deenan, Schwenk Achim, Anderson Jane, Porter Kholoud, Gompels Mark, Sabin Caroline A
Research Department of Infection and Population Health, Division of Population Health, UCL Medical School, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK.
Haematologica. 2009 Jun;94(6):875-80. doi: 10.3324/haematol.2008.002691. Epub 2009 Mar 31.
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 log(2)(cells/mm(3)) 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.
自从高效抗逆转录病毒疗法问世以来，HIV感染个体中非霍奇金淋巴瘤的发病率有所下降。我们在英国CHIC研究中描述了1996年至2006年期间系统性非霍奇金淋巴瘤的发病率趋势，并评估了免疫抑制与系统性非霍奇金淋巴瘤发生之间的关联：286/23155（1.2%）的个体发生了艾滋病定义的淋巴瘤（258例为系统性淋巴瘤）。年龄较小、接受高效抗逆转录病毒疗法以及较晚的日历年均与系统性非霍奇金淋巴瘤风险降低独立相关。在接受过（每log(2)(细胞/mm³)较高时相对风险：0.62）和未接受过（0.70）高效抗逆转录病毒疗法的患者中，较低的最新CD4细胞计数与系统性非霍奇金淋巴瘤密切相关。与其他免疫抑制指标的关联，包括最低CD4细胞计数、严重免疫抑制的经历和持续时间，通常较弱。提倡更早开始高效抗逆转录病毒疗法并更广泛地进行HIV检测，以降低系统性非霍奇金淋巴瘤的风险。
