Immune reconstitution inflammatory syndrome versus non-immune reconstitution inflammatory syndrome lymphoma in HIV patients on antiretroviral therapy

Abstract

Little is known about differences between immune reconstitution inflammatory syndrome (IRIS) and non-IRIS lymphoma in HIV patients on antiretroviral therapy (ART). The aim of this study was to describe the characteristics of IRIS and non-IRIS lymphoma in Korean HIV-positive patients on ART compared with lymphoma in those off ART. Of 1490 patients, 41 (3%) had lymphoma. Of these, 27 cases (66%) were classified as lymphoma off ART, eight as IRIS lymphoma, and six as non-IRIS lymphoma on ART. Hodgkin lymphoma was significantly more common among patients with non-IRIS lymphoma on ART than among those with lymphoma off ART (P = 0.005), whereas there was no Hodgkin lymphoma among IRIS lymphoma. Stage IV lymphoma was significantly rarer in non-IRIS lymphoma on ART than in lymphoma off ART (P = 0.007). Non-IRIS lymphoma on ART tends to have a better survival rate than lymphoma off ART (Kaplan–Meier survival analysis, P = 0.167), while IRIS lymphoma exhibited a survival rate similar to lymphoma off ART (P = 0.618). In Korean HIV-positive patients, there were significantly more cases of Hodgkin lymphoma of a less advanced stage in non-IRIS lymphoma on ART than in lymphoma off ART, in contrast to IRIS lymphoma.

Keywords

HIV AIDS cancer lymphoma immune reconstitution inflammatory syndrome

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References

Gopal

Patel

Achenbach

. Lymphoma immune reconstitution inflammatory syndrome in the center for AIDS research network of integrated clinical systems cohort. Clin Infect Dis 2014; 59: 279–286.

Clarke

Glaser

Gomez

. Lymphoid malignancies in U.S. Asians: incidence rate differences by birthplace and acculturation. Cancer Epidemiol Biomarkers Prev 2011; 20: 1064–1077.

Evens

Antillon

Aschebrook-Kilfoy

. Racial disparities in Hodgkin's lymphoma: a comprehensive population-based analysis. Ann Oncol 2012; 23: 2128–2137.

Novak

Richardson

Buchacz

. Immune reconstitution inflammatory syndrome: incidence and implications for mortality. AIDS 2012; 26: 721–730.

Herida

Mary-Krause

Kaphan

. Incidence of non-AIDS-defining cancers before and during the highly active antiretroviral therapy era in a cohort of human immunodeficiency virus-infected patients. J Clin Oncol 2003; 21: 3447–3453.

Cobucci

Lima

de Souza

. Assessing the impact of HAART on the incidence of defining and non-defining AIDS cancers among patients with HIV/AIDS: a systematic review. J Infect Public Health 2014; 8: 1–10.

Kim

Lee

. WHO Classification of malignant lymphomas in Korea: report of the third nationwide study. Korean J Pathol 2011; 45: 254–260.

Kirk

Pedersen

Cozzi-Lepri

. Non-Hodgkin lymphoma in HIV-infected patients in the era of highly active antiretroviral therapy. Blood 2001; 98: 3406–3412.

Park

Choe

. Immune reconstitution inflammatory syndrome in the first year after HAART: influence on long-term clinical outcome. AIDS 2006; 20: 2390–2392.

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