The impact of HCV co-infection on the outcome and the clinical features of HIV-related non-Hodgkin lymphoma (NHL)

Abstract

19504 Background: Epidemiological studies show an association between HCV and B NHL. Treatment and outcome of patients with NHL and HCV infection in the general population and in HIV-infected population are still debated. Methods: HIV-infected individuals with NHL diagnosed and treated at the National Cancer Institute of Aviano (Italy) from April 1991 to October 2006, whose serology for HCV- infection was known at NHL diagnosis, were enrolled in the study. The aim of the study was to describe and compare clinical features and outcome of NHL in HIV patients with or without HCV co-infection. Co-infected and mono-infected patients were treated with the same therapeutical protocols. Results: 301 HIV-infected patients with NHL were included in the study: 123 (40.2%) HCV co-infected and 178 mono-infected. As regards HIV disease’s characteristics the co-infected patients had a significantly higher percentage of intravenous drug users (IDUs) in comparison with mono-infected patients, whereas no significant differences were seen in CD4, CD8 count, HIV viral load, AIDS-defining condition at NHL diagnosis and antiretroviral therapy. As regards NHL’s characteristics at the onset, co- infected patients showed a significantly lower percentage of Burkitt histotype, whereas no significant differences were seen in Performance Status, stage and International Prognostic Index. Co-infected patients showed a significant higher NHL involvement of the spleen. No differences were observed in response rate (RR), complete response rate (CRR) and overall survival (OS) at 5 years. Co-infected patients had a significantly higher percentage of G3-G4 liver toxicity during chemotherapy (4.5% vs 0%; p=0.0083) although it was not life threatening. Conclusion: Co-infected patients had a significantly higher rate of IDUs as risk factor for HIV infection, of Burkitt lymphoma among lymphoma histotypes, and of spleen involvement as NHL site. No other differences were observed in the characteristics of HIV and NHL disease. No differences in RR, CRR and OS were observed between co- and mono-infected patients, although a higher rate of liver toxicity was observed in co-infected patients. No significant financial relationships to disclose.