AEGiS-15IAC: HAART reduces incidence and improves the long-term prognosis of HIV-associated lymphoma.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

HAART reduces incidence and improves the long-term prognosis of HIV-associated lymphoma.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. ThOrB1403)

Wolf T, Chow K, Mitrou P, Helm E, Mantzsch K, Brodt H
Hospital of the JWG University, Frankfurt, Germany

BACKGROUND: Non-Hodgkin's lymphoma is an AIDS-defining disease. A retrospective analysis has been performed in order to determine the impact that HAART has made on incidence, prognosis and risk factors of ARL. We collected data 214 cases of ARL treated at our centre from 1984 to May 2003 and analyzed it using the Kaplan-Meier-, log rank- and Cox proportional hazard-model.

RESULTS: The incidence of NHL increased in the early study periods up to a peak of 14.83 per 1,000 patient years between 1991 and 1994. In the subsequent periods from 1995 onwards however, it decreased to 3.7 in 1,000 patient years. The incidence of PCNSL took the same development (Table 1 and Fig. 1). Table 1 [table: see text]<IMG SRC="images/prog/ThOrB1403_IMG01.jpg" border=0>Table 2 [table: see text]<IMG SRC="images/prog/ThOrB1403_IMG01.jpg" border=0>Fig. 1 Survival was significantly associated with complete remission and virological in the Kaplan Meier test. Survival for HAART responders was significantly better. Non-responders had a median survival period of 201 days, whereas more than 50% had survived in the responder group (Fig. 2).<IMG SRC="images/prog/ThOrB1403_IMG06.jpg" border=0>Fig. 2 Analysing all patients in the HAART-era survival was significantly better if patients went into CR (n=28), the median survival again has not been reached for patients with CR and was only 149 days otherwise. Further analysis showed no significant differences for the use of protease inhibitors as well as for virological response being achieved before the diagnosis of NHL. Histological types of NHL differed strongly between HAART and pre-HAART era. When using the Cox model, complete remission overrides viral response and thus remained the only factor independently associated with survival (Table 2). Table 2 [table: see text]

CONCLUSIONS: HAART improves the prognosis of ARL, but only complete remission after chemotherapy remains independently associated with survival. The immediacy of viral response has not been associated with better prognosis. These figures illustrate the need for prospective studies examining the coadministration of HAART and chemotherapy according based on the risk factors determined.

Keywords: AEGIS, Antiretroviral Therapy, Highly Active, Acquired Immunodeficiency Syndrome, Incidence, HIV, HIV Seropositivity, HIV Infections, Prognosis, HIV-1, Lymphoma, Non-Hodgkin, Anti-HIV Agents, Proportional Hazards Models, Risk Factors, Prospective Studies, Humans, epidemiology

040711
ThOrB1403