HIV-Associated Hodgkin's Lymphoma in HIV-Infected Patients
HIV-Associated Hodgkin's Lymphoma in HIV-Infected Patients
We found a prevalence of 6.3 cases per 1000 HIV-positive patients per year over a period of 10 years in our HIV outpatient clinic, totaling 14 patients with pathologically confirmed HIV + HL. Eighty percent of the patients were African American, 15% Hispanic, and 5% White. In all, 85% were male. The average age at diagnosis was 43 years. Unlike what has been described for HIV-negative HL, we did not observe a bimodal distribution.
The mean absolute CD4 count before treatment was 284 cells/mm and after treatment was 194 cells/mm. Plasma HIV viral load ranged from 89 to 210 000 copies/mL before HL treatment and from 344 to 302 000 copies/mL after HL treatment.
The average time from the diagnosis of HIV infection to the diagnosis of HIV + HL was 7.6 years. The mean hemoglobin was 9.8 g/dL, with an average of 2.8 g/dL for albumin. All patients demonstrated at least 1 comorbidity (hypertension, chronic obstructive pulmonary disease, and diabetes mellitus). Two patients (14%) had other diagnosed cancers, including cervical and lung cancers. Six (43%) of the patients were diagnosed with an AIDS-associated opportunistic infection before the diagnosis of HIV + HL. Twenty-one percent had family history of cancer.
The most common histopathologic type wasmixed cellularity followed by lymphocytic predominance. It is important to note that in our small case series, 2 patients did not have any information in relation to histopathology. Eighty-six percent of the patients received chemotherapy treatment with ABVD. The majority of patients had 6 cycles delivered. In terms of HL staging, 87% presented with advanced stages (III B or IV). To the best of our knowledge, 4 of the 14 patients remain alive.
A great proportion of patients presented with weight loss, fever, and fatigue (10 of 14). Eighty-seven percent of patients were of antiretroviral treatment (mainly NRTI and NNRTI combination). In 13% of the patients, information was not available. Table 1 and Table 2 show information on patients and their characteristics.
Results
We found a prevalence of 6.3 cases per 1000 HIV-positive patients per year over a period of 10 years in our HIV outpatient clinic, totaling 14 patients with pathologically confirmed HIV + HL. Eighty percent of the patients were African American, 15% Hispanic, and 5% White. In all, 85% were male. The average age at diagnosis was 43 years. Unlike what has been described for HIV-negative HL, we did not observe a bimodal distribution.
The mean absolute CD4 count before treatment was 284 cells/mm and after treatment was 194 cells/mm. Plasma HIV viral load ranged from 89 to 210 000 copies/mL before HL treatment and from 344 to 302 000 copies/mL after HL treatment.
The average time from the diagnosis of HIV infection to the diagnosis of HIV + HL was 7.6 years. The mean hemoglobin was 9.8 g/dL, with an average of 2.8 g/dL for albumin. All patients demonstrated at least 1 comorbidity (hypertension, chronic obstructive pulmonary disease, and diabetes mellitus). Two patients (14%) had other diagnosed cancers, including cervical and lung cancers. Six (43%) of the patients were diagnosed with an AIDS-associated opportunistic infection before the diagnosis of HIV + HL. Twenty-one percent had family history of cancer.
The most common histopathologic type wasmixed cellularity followed by lymphocytic predominance. It is important to note that in our small case series, 2 patients did not have any information in relation to histopathology. Eighty-six percent of the patients received chemotherapy treatment with ABVD. The majority of patients had 6 cycles delivered. In terms of HL staging, 87% presented with advanced stages (III B or IV). To the best of our knowledge, 4 of the 14 patients remain alive.
A great proportion of patients presented with weight loss, fever, and fatigue (10 of 14). Eighty-seven percent of patients were of antiretroviral treatment (mainly NRTI and NNRTI combination). In 13% of the patients, information was not available. Table 1 and Table 2 show information on patients and their characteristics.
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