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 Blood, 4 June 2009, Vol. 113, No. 23, pp. 5737-5742.
Prepublished online as a Blood First Edition Paper on March 31, 2009; DOI 10.1182/blood-2009-02-204172.

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CLINICAL TRIALS AND OBSERVATIONS

Hodgkin lymphoma in the Swiss HIV Cohort Study

Gary M. Clifford1, Martin Rickenbach2, Mauro Lise3, Luigino Dal Maso3, Manuel Battegay4, Julia Bohlius5, Emmanuelle Boffi El Amari6, Urs Karrer7, Gernot Jundt8, Andrea Bordoni9, Silvia Ess10, Silvia Franceschi1, and for the Swiss HIV Cohort Study

1 International Agency for Research on Cancer, Lyon, France; 2 Coordination and Data Center, Swiss HIV Cohort Study, Lausanne, Switzerland; 3 Epidemiology and Biostatistics Unit, Aviano Cancer Center, Aviano, Italy; 4 Division of Infectious Diseases, University Hospital Basel, Basel, Switzerland; 5 Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; 6 Geneva University Hospital, Geneva, Switzerland; 7 Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, Zurich, Switzerland; 8 Cancer Registry of Basel, Basel, Switzerland; 9 Cancer Registry of the Canton of Ticino, Locarno, Switzerland; and 10 Cancer Registry of St Gallen and Appenzell, St Gallen, Switzerland

Hodgkin lymphoma (HL) risk is elevated among persons infected with HIV (PHIV) and has been suggested to have increased in the era of combined antiretroviral therapy (cART). Among 14 606 PHIV followed more than 20 years in the Swiss HIV Cohort Study (SHCS), determinants of HL were investigated using 2 different approaches, namely, a cohort and nested case-control study, estimating hazard ratios (HRs) and matched odds ratios, respectively. Forty-seven incident HL cases occurred during 84 611 person-years of SHCS follow-up. HL risk was significantly higher among men having sex with men (HR vs intravenous drug users = 2.44, 95% confidence interval [CI], 1.13-5.24) but did not vary by calendar period (HR for 2002-2007 vs 1995 or earlier = 0.65, 95% CI, 0.29-1.44) or cART use (HR vs nonusers = 1.02, 95% CI, 0.53-1.94). HL risk tended to increase with declining CD4+ cell counts, but these differences were not significant. A lower CD4+/CD8+ ratio at SHCS enrollment or 1 to 2 years before HL diagnosis, however, was significantly associated with increased HL risk. In conclusion, HL risk does not appear to be increasing in recent years or among PHIV using cART in Switzerland, and there was no evidence that HL risk should be increased in the setting of improved immunity.


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R. Dolcetti, P. De Paoli, and D. Serraino
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