Epidemiology Of Hivassociated Hodgkins Lymphoma

Although HD occurs quite frequently in patients with HIV, both illnesses affect similar age groups, and there was debate as to whether the incidence is increased in people with HIV. Cohort studies from San Francisco98 and New York99 early in the HIV epidemic failed to identify an increased risk, and to this day HD is not an AIDS-defining diagnosis. However, subsequent subgroup analysis of the New York data suggested that there was an increased incidence of HD among intravenous drug users (IVDU) with HIV. Moreover, the Italian Cooperative group for AIDS-related tumors described 35 patients with HIV and HD and almost all of these patients were IVDU.100

More recent cohort studies, including the San Francisco City Clinic cohort101 and multicenter AIDS cohort study (MACS),102 report a relative risk of 19 compared to the age-adjusted general population. The most comprehensive data to date come from large linkage studies across the United States and Puerto Rico, which gave a relative risk of 7.6.103 This figure has been repeated in other large linkage studies and is significantly lower than that for NHL in patients with HIV. The difference between the early small cohorts and these later large cohorts is probably due to the small number of HD cases seen rather than due to a real change in incidence over time. Since the introduction of HAART, the incidence of some AIDS-related malignancies such as KS and primary cerebral lymphoma has fallen while of others such as systemic NHL appears to be unchanged. There are as yet no reports that describe the effect of HAART usage on the incidence of HD.

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