Epidemiology Of Aidsrelated Lymphoma In Era Of Haart

NHLs are associated with both congenital and iatro-genic immunosuppression, and so it was perhaps not surprising that an increased incidence was demonstrated early in the AIDS epidemic. Registry linkage studies in the pre-HAART era found that the incidence of NHL in HIV-positive individuals was 60-200 times higher than in the matched HIV-negative popula-tion8,9 and the relative risk was even greater for primary cerebral lymphomas. Following the introduction of HAART, the incidence of both KS and primary cerebral lymphoma has fallen significantly in both registry linkage and cohort studies.10-12 In contrast the effects on systemic NHL are less clear although some cohort studies suggest a modest nonsignificant decline in the inci-dence,13-15 including in the hemophilia population.16

An international meta-analysis of 20 cohort studies compared the incidence of systemic NHL between 1992-1996 and 1997-1999. This meta-analysis confirmed an overall reduction in the incidence of both primary cerebral lymphoma (rate ratio = 0.42) and systemic immunoblastic lymphoma (rate ratio = 0.57) but not Burkitt's lymphoma (rate ratio = 1.18).17

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