CD4 counts and the risk of systemic non-Hodgkin's lymphoma in individuals with HIV in the UK
CD4 counts and the risk of systemic non-Hodgkin's lymphoma in individuals with HIV in the UK
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DOI：
10.3324/haematol.2008.002691
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发表时间：
2009-06-01
期刊：
影响因子：
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通讯作者：
Sabin, Caroline A.
中科院分区：
文献类型：
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作者：
Bower, Mark;Fisher, Martin;Sabin, Caroline A.
自从采用高效抗逆转录病毒疗法以来，艾滋病毒感染者中非霍奇金淋巴瘤的发病率有所下降。我们描述了1996 - 2006年英国CHIC研究中系统性非霍奇金淋巴瘤发病率的趋势，并评估了免疫抑制与系统性非霍奇金淋巴瘤发展之间的关系：23，155例患者中有286例（1.2%）发展为AIDS定义的淋巴瘤（258例系统性）。年龄小、接受高效抗逆转录病毒治疗和较晚的日历年都与系统性非霍奇金淋巴瘤风险降低独立相关。较低的最新CD 4计数与系统性非霍奇金淋巴瘤密切相关，在接受过高效抗逆转录病毒治疗的患者中（RR/log（2）（细胞/mm（3））较高：0.62）和未接受过高效抗逆转录病毒治疗的患者中（0.70）。与其他免疫抑制措施，包括最低CD 4计数，经验和严重免疫抑制的持续时间，一般较弱。早期高活性抗逆转录病毒治疗的启动和更广泛地获得艾滋病毒检测的主张，以减少系统性非霍奇金淋巴瘤的风险。
Since the introduction of highly active antiretroviral therapy, there has been a decline in the incidence of non-Hodgkin's lymphoma among HIV-infected individuals. We described trends in the incidence of systemic non-Hodgkin's lymphoma in the UK CHIC Study from 19962006 and evaluated the association between immunosuppression and development of systemic non-Hodgkin's lymphoma: 286/23,155 (1.2%) individuals developed an AIDS-defining lymphoma (258 systemic). Younger age, receipt of highly active antiretroviral therapy and later calendar year were all independently associated with a reduced risk of systemic non-Hodgkin's lymphoma. A lower latest CD4 count was strongly associated with systemic non-Hodgkin's lymphoma, in patients who had (RR per log(2)(cells/mm(3)) higher: 0.62) and had not (0.70) received highly active antiretroviral therapy. Associations with other measures of immunosuppression, including nadir CD4 count, experience and duration of severe immunosuppression, were generally weaker. Earlier highly active antiretroviral therapy initiation and wider access to HIV testing is advocated to reduce the risk of systemic non-Hodgkin's lymphoma.