Incidence and prognosis of AIDS-related lymphoma have improved since the advent of HAART

The incidence of systemic and primary brain AIDS-related lymphoma (ARL) has reduced since the introduction of HAART, French investigators report. They also find that prognosis of ARL has improved during this time.

Dr Caroline Besson of Hôpital Necker in Paris and colleagues at sites around France report the findings in the October 15 issue of Blood. They note that while the use of HAART has led to a decrease in the incidence of AIDS-defining illnesses, the consequences of HAART on ARL are -under debate. –

This study compared the incidence and characteristics of ARL before and after the use of HAART in a large population of HIV infected patients recorded in the French Hospital Database on HIV, including 145 patients with proven lymphoma. They compared the periods 1993-4 and 1997-8.

The researchers found that the incidence of systemic ARL decreased during that time from 86.0 per 10,000 person-years to 42.9 per 10,000 person-years. The incidence of primary brain lymphoma has also fallen dramatically between the periods, from 27.8 per 10,000 to 9.7 per 10,000 person-years.

Another analysis shows known HIV history was longer in the second period than in the first among patients with systemic ARL (98 versus 75 months). Patients had higher CD4 counts at diagnosis during the second period (191 versus 63µL). Survival of patients with systemic ARL increased between the periods from 6 to 20 months.

Therefore, the researchers conclude, -the profile of ARL has changed since the era of HAART, with a lower incidence of systemic and brain ARL. The prognosis of systemic ARL has improved.

Besson C, Goubar A, Gabarre J, Rozenbaum W et al. Changes in AIDS-related lymphoma since the era of highly active antiretroviral therapy. Blood 2001;98:2339-2344.