The incidence of non-Hodgkin lymphoma has decreased significantly since the introduction of HAART

The major European study project, EuroSIDA, has published further evidence that there has been a significant decrease in the incidence of non-Hodgkin lymphomas (NHL) in people with HIV since the widespread use of highly active antiretroviral therapy (HAART).

The new evidence is published by Dr Ole Kirk and colleagues at the EuroSIDA Coordinating Centre at Hvidovre Hospital, Copenhagen, who studied the impact of HAART on NHL within EuroSIDA’s multicentre observational cohort of more than 8,500 patients across Europe. They studied the incidences of NHL and subtypes including Burkitt, immunoblastic, primary brain lymphoma (PBL) and lymphomas of other or unknown histology in people on combinations of three or more antiretrovirals, who they followed from May 1994 to the end of 2000.

The researchers found that the incidence of NHL in the cohort fell 6-fold following the introduction of HAART. Over 26,764 person-years of prospective follow-up (PYF) the incidence of NHL decreased from 1.99 before September 1995 to 0.30 cases per 100 PYF after March 1999. The incidence of all subtypes of NHL decreased significantly, but most pronouncedly for primary brain lymphoma, the researchers report in the 1 December issue of the journal Blood. They write that the latest CD4 T cell count and plasma viral load were both significantly associated with diagnosis of NHL.

They conclude: “The Incidence of NHL among HIV-infected patients has decreased significantly after the introduction of HAART, and the decline was most pronounced for PBL. After starting HAART, patients with insufficient immunologic and virologic response were at highest risk of NHL.”