Inserm, Paris, France.
Blood. 2011 Jul 7;118(1):44-9. doi: 10.1182/blood-2011-02-339275. Epub 2011 May 6.
Hodgkin lymphoma (HL) incidence with HIV infection may have increased with the introduction of combination antiretroviral therapy (cART), suggesting that immune reconstitution may contribute to some cases. We evaluated HL risk with cART during the first months of treatment. With 187 HL cases among 64 368 HIV patients in France, relative rates (RRs) and 95% confidence intervals (CIs) of HL were estimated using Poisson models for duration of cART, CD4 count, and HIV load, with and without adjustment for demographic/clinical covariates. HL risk was unrelated to cART use overall, but it was related to time intervals after cART initiation (P = .006). Risk was especially and significantly elevated in months 1-3 on cART (RR 2.95, CI 1.64-5.31), lower in months 4-6 (RR 1.63), and null with longer use (RR 1.00). CD4 count was strongly associated with HL risk (P < 10⁻⁶), with the highest HL incidence at 50-99 CD4 cells/mm³. With adjustment for CD4 count and covariates, HL risk was elevated, but not significantly (RR 1.42), in months 1-3 on cART. HIV load had no added effect. HL risk increased significantly soon after cART initiation, which was largely explained by the CD4 count. Further studies of HIV-associated HL are needed.
HIV 感染者霍奇金淋巴瘤（HL）的发病率可能随着联合抗逆转录病毒治疗（cART）的应用而增加，这表明免疫重建可能是导致部分病例的原因之一。我们评估了 cART 治疗初期阶段 HL 的发病风险。在法国，64368 例 HIV 患者中有 187 例 HL 病例，我们使用泊松模型评估 cART 持续时间、CD4 计数和 HIV 载量与 HL 风险的关系，同时调整了人口统计学/临床协变量。总体而言，cART 的使用与 HL 风险无关，但与 cART 开始后的时间间隔有关（P =.006）。cART 治疗 1-3 个月时风险尤其显著升高（RR 2.95，95%CI 1.64-5.31），4-6 个月时降低（RR 1.63），而长时间使用时风险则接近为零（RR 1.00）。CD4 计数与 HL 风险密切相关（P < 10⁻⁶），CD4 计数为 50-99 个细胞/mm³时 HL 发病率最高。调整 CD4 计数和协变量后，cART 治疗 1-3 个月时 HL 风险升高，但无统计学意义（RR 1.42）。HIV 载量无附加作用。cART 治疗初期 HL 风险显著增加，这主要归因于 CD4 计数。需要进一步研究 HIV 相关性 HL。
