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Prognosis of HIV-associated non-Hodgkin lymphoma in patients starting combination antiretroviral therapy

Weller, I; Costagliola, D; Ledergerber, B; Lundgren, J; Chene, G; Touloumi, G; Warszawski, J; ... European AIDS Treatment Grp, ; + view all (2009) Prognosis of HIV-associated non-Hodgkin lymphoma in patients starting combination antiretroviral therapy. AIDS , 23 (15) 2029 - 2037. 10.1097/QAD.0b013e32832e531c.

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Abstract

Objective: We examined survival and prognostic factors of patients who developed HIV-associated non-Hodgkin lymphoma (NHL) in the era of combination antiretroviral therapy (cART).Design and setting: Multicohort collaboration of 33 European cohorts.Methods: We included all cART-naive patients enrolled in cohorts participating in the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) who were aged 16 years or older, started cART at some point after 1 January 1998 and developed NHL after 1 January 1998. Patients had to have a CD4 cell count after 1 January 1998 and one at diagnosis of the NHL. Survival and prognostic factors were estimated using Weibull models, with random effects accounting for heterogeneity between cohorts.Results: Of 67 659 patients who were followed up during 304940 person-years, 1176 patients were diagnosed with NHL. Eight hundred and forty-seven patients (72%) from 22 cohorts met inclusion criteria. Survival at 1 year was 66% [95% confidence interval (CI) 63-70%] for systemic NHL (n = 763) and 54% (95% CI: 43-65%) for primary brain lymphoma (n = 84). Risk factors for death included low nadir CD4 cell counts and a history of injection drug use. Patients developing NHL on cART had an increased risk of death compared with patients who were cART naive at diagnosis.Conclusion: In the era of cART two-thirds of patients diagnosed with HIV-related systemic NHL survive for longer than 1 year after diagnosis. Survival is poorer in patients diagnosed with primary brain lymphoma. More advanced immunodeficiency is the dominant prognostic factor for mortality in patients with HIV-related NHL. (C) 2009 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins

Type: Article
Title: Prognosis of HIV-associated non-Hodgkin lymphoma in patients starting combination antiretroviral therapy
DOI: 10.1097/QAD.0b013e32832e531c
Keywords: antiretroviral therapy, cohort studies, collaborative study, Europe, mortality, non-Hodgkin lymphoma, prognosis, HUMAN-IMMUNODEFICIENCY-VIRUS, AIDS-RELATED LYMPHOMA, PROSPECTIVE COHORT, INFECTED PATIENTS, CELL LYMPHOMA, ERA, CHEMOTHERAPY, SURVIVAL, CANCER, RISK
UCL classification: UCL > School of Life and Medical Sciences
UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health Care > Infection and Population Health
UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Child Health
URI: http://discovery.ucl.ac.uk/id/eprint/164204
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