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10th Anniversary Conference Of The British HIV Association [BHIVA]15 – 17 April 2004, City Hall, Cardiff, UK |
[AUTHOR(S):] A Waterston, J Stebbing, C Thirlwell, T Newsom-Davis, S Mandalia, MR Nelson, BG Gazzard, M Bower
Chelsea and Westminster Hospital, London, UK
BHIVA Conf 2004 Apr 15-17;10:O28
BACKGROUND: As HIV increases the risk of NHL, we measured the influence of highly active antiretroviral therapy (HAART) on this risk.
METHODS: The protective effect of HAART was examined in a prospective cohort of 9621 HIV-infected individuals. Lymphocyte subset data were also examined.
RESULTS: 280 patients were diagnosed with lymphoma (206 with systemic NHL, 55 with primary cerebral lymphoma and 19 with Hodgkin's disease). During the HAART era (1996–2003), 5832 individuals were identified as at risk and 102 patients were diagnosed with systemic NHL. Univariate analysis demonstrated that increased age, higher nadir CD4 and CD8 cell counts, CD19 B cell count, CD16/56 natural killer count and exposure to non-nucleoside reverse transcriptase inhibitor (NNRTI) or protease inhibitor (PI)-containing HAART conferred significant protection against NHL (P<0.05). In a multivariate analysis, age, nadir CD4 and CD8 cell counts and exposure to HAART were independent predictors of risk of NHL (P<0.02). NNRTIbased HAART [adjusted rate ratio 0.4, 95% confidence interval (CI) 0.3–0.5] had an identical protective effect to PI-based HAART and were both significantly more protective than nucleoside reverse transcriptase inhibitors alone (rate ratio 0.5, 95% CI 0.4–0.7) or no antiretrovirals (P<0.001).
CONCLUSIONS: HAART-induced maintenance of CD4 and CD8 counts protects patients from systemic AIDS-related NHL.
PRESENTING AUTHOR: A Waterston
040415
O28
Copyright © 2004 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD