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Blood, 1 December 2006, Vol. 108, No. 12, pp. 3786-3791. Prepublished online as a Blood First Edition Paper on August 17, 2006; DOI 10.1182/blood-2006-05-024109. This Article Full Text (PDF) Supplemental Appendix All Versions of this Article: blood-2006-05-024109v1 108/12/3786    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Biggar, R. J Articles by Engels, E. A Search for Related Content PubMed PubMed Citation Articles by Biggar, R. J Articles by Engels, E. A Related Collections Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted May 23, 2006 Accepted July 24, 2006 Hodgkin lymphoma and immunodeficiency in persons with HIV/AIDS Robert J Biggar*, Elaine S Jaffe, James J Goedert, Anil Chaturvedi, Ruth Pfeiffer, and Eric A Engels National Cancer Institute, National Institutes of Health, Dept of Health & Human Services, MD, USA * Corresponding author; email: biggarb{at}mail.nih.gov. In persons with HIV/AIDS (PWHA), Hodgkin lymphoma (HL) risk is increased. However, HL incidence in PWHA has unexpectedly increased since highly active anti-retroviral therapy (HAART) was introduced. We linked nationwide HIV/AIDS and cancer registry data from 1980 through 2002. Immunity was assessed by CD4 T-lymphocyte counts within -6 to +3 months of onset. Annual HL incidence rates were calculated for 4 through 27 months after AIDS onset. During 477,368 person-years (py) of follow-up in 317,428 persons with AIDS (PWA), 173 HL cases occurred (36.2 per 105 py). Incidence was significantly higher in 1996-2002 than earlier. Incidence peaked in PWA with 150-199 CD4 cells/L (53.7 per 105 py), whereas it was 20.7 in PWA with <50 CD4 cells/L (ptrend= 0.002). For each HL subtype, incidence decreased with declining CD4 counts, but nodular sclerosing decreased more precipitously than mixed cellularity incidence, thereby increasing the proportion of mixed cellularity HL seen in PWA. HL incidence is lower with severe immunosuppression than with moderate immunosuppression. With more severe immunosuppression, nodular sclerosing HL becomes infrequent, explaining the higher proportion of mixed cellularity HL found in PWA. Thus, HAART-related improvements in CD4 counts likely explain the increasing HL incidence in PWHA observed since 1996. With more severe immunosuppression, nodular sclerosing HL becomes infrequent, explaining the higher proportion of mixed cellularity HL found in PWA. Pathogenesis implications are discussed. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Hodgkin lymphoma: to the HAART of the matter Alexandra M. Levine Blood 2006 108: 3630. [Full Text] [PDF] This article has been cited by other articles: V. E. Stone, B. C. Bounds, V. V. Muse, and J. A. Ferry Case 29-2009 -- An 81-Year-Old Man with Weight Loss, Odynophagia, and Failure to Thrive N. Engl. J. Med., September 17, 2009; 361(12): 1189 - 1198. [Full Text] [PDF] R. Dolcetti, P. De Paoli, and D. Serraino Degree of immune suppression and risk of HIV-related Hodgkin lymphoma: time points matter Blood, September 10, 2009; 114(11): 2354 - 2354. [Full Text] [PDF] G. Clifford, S. Franceschi, and M. 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