Lymphoma incidence 15 times higher in HIV/HCV coinfection
The incidence of lymphoma — Hodgkin and non-Hodgkin — was up to 15 times higher among patents with HIV monoinfection and HIV/hepatitis C virus coinfection compared with the general population, according to findings presented at the International Liver Congress in Paris.
Alvaro Mena de Cea, MD, PhD, of the Institute of Biomedical Research and La Coruña University Hospital Complex in Spain, and colleagues used a database at their tertiary care hospital to compare the incidence of HL and NHL among patients with HIV and HIV/HCV coinfection with that of the general population between 1993 to 2014. They also analyzed the time from HIV infection to the development of lymphoma.
Overall, 2,318 patients were included in the study, 37% of whom had HIV/HCV coinfection. Lymphomas were identified in 63 cases, the researchers said. Of these, 37 were diagnosed in HIV-monoinfected patients and 27 were diagnosed in HIV/HCV-coinfected patients, with no significant difference in risk between the two patient groups (OR = 1.25; 95% CI, 0.76-2.97).
Although no significant difference was observed between HIV-monoinfected and HIV/HCV-coinfected patients, Mena de Cea and colleagues said the survival rate 2 years after diagnosis was better for patients with HL (86.6%) compared with those with NHL (32.5%).
The researchers found that the standard incidence rate (SIR) of all diagnosed lymphomas in HIV-monoinfected and HIV/HCV-coinfected patients was 15 (95% CI, 9.1-24.7). The SIR of HL and NHL in HIV monoinfection and HIV/HCV coinfection was 17.2 (95% CI, 5-60.3) and 15.6 (95% CI, 9.4-29.7), respectively. The SIR of HL in HIV/HCV-coinfected patients was 28.4 (95% CI, 8.3-98.8) — an incidence the researchers called “remarkable” — and the SIR of NHL in the same population was 12.1 (95% CI, 6.8-23.4).
Mena de Cea and colleagues also found that lymphomas in HIV/HCV-coinfected patients developed later than in HIV-monoinfected patients. For example, lymphoma was diagnosed in the first year for 64.9% of HIV-monoinfected patients vs. 25.9% of HIV/HCV-coinfected patients.
“We have the perception (and there are more data supporting this) that HCV increases the risk for NHL and HL in [people living with HIV (PLWH)], and the favorable impact of highly active ART on lymphomas in HIV/HCV-coinfected patients is minimized,” Mena de Cea told Infectious Disease News. “We hypothesize that the eradication of HCV infection in PLWH will decrease the incidence of virally suppressed PLWH.” – by Marley Ghizzone
Mena de Cea A, et al. Abstract 418. Presented at: The International Liver Congress; April 11-15, 2018; Paris.
Disclosures: Mena de Cea reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.