Abstract
BackgroundNon-Hodgkin lymphoma (NHL) is the most common cancer in people with HIV. Although 95% of HIV patients are in developing countries like Peru, the majority of these studies have been conducted in developed countries. In this study we aim to evaluate prognostic factors associated with outcomes in HIV positive patients undergoing systemic therapy for treatment of NHL.MethodsThis retrospective study includes patients with NHL seen in the Instituto Nacional de Enfermedades Neoplasicas (INEN) between 2004 to 2014. Patients were divided into two groups: antiretroviral therapy (ART) -naïve (n = 34) and those previously treated, ART-exposed (n = 13), at the time of diagnosis. All patients received chemotherapy and ART. The medical records were reviewed. Data were analyzed using t-test and chi-square test. Survival curves were estimated by the Kaplan-Meier method and comparison was done by log-rank test. Multivariate analysis for overall survival (OS) was performed with the Cox proportional hazard regression model.ResultsAll ART-exposed patients were from the capital city (p = 0.039); they had significantly lower hemoglobin levels compared to ART-naïve patients (p = 0.026). The median OS was 47.7 months with a 5-yr OS of 36.1%. The median OS for ART naïve patients was significantly higher than that for ART-exposed patients (57.05 and 21.09 months, respectively; p = 0.018). Advanced stage and low serum albumin were associated with lower OS in both groups. Age > 60 was associated with worse outcomes in the ART-naïve cohort.ConclusionsAdvanced stage, low serum albumin and previous ART treatment were the primary prognostic factors associated with poorer outcomes in patients with NHL and HIV infection. In ART-naïve patients, age > 60 was associated with worse outcomes but in this cohort, older patients still had better overall outcomes than ART-exposed patients.
Highlights
Non-Hodgkin lymphoma (NHL) is the most common cancer in people with human immunodeficiency virus (HIV)
In an attempt to improve the limitations of previous studies, we studied the overall survival (OS) and prognostic factors in HIV-positive patients with systemic NHL in the post-antiretroviral therapy (ART) era at the Intistituto Nacional de Enfermedades Neoplásicas (INEN) in Peru
This retrospective study included HIV-positive patients treated by the Department of Infectious Diseases of INEN who were diagnosed with NHL between the years 2004 and 2015
Summary
Non-Hodgkin lymphoma (NHL) is the most common cancer in people with HIV. In this study we aim to evaluate prognostic factors associated with outcomes in HIV positive patients undergoing systemic therapy for treatment of NHL. Non-Hodgkin lymphoma (NHL) is the most common cancer in patients with human immunodeficiency virus (HIV) and is one of the leading causes of death in this population [1]. NHL is an AIDS-defining disease in people infected with HIV-1. Several studies have compared the evolution of NHL in the pre-ART and post-ART eras [5, 6]. In an attempt to improve the limitations of previous studies, we studied the overall survival (OS) and prognostic factors in HIV-positive patients with systemic NHL in the post-ART era at the Intistituto Nacional de Enfermedades Neoplásicas (INEN) in Peru
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