High Risk Features Contrast With Favorable Outcomes in HIV-associated Hodgkin Lymphoma in the Modern cART Era, ANRS CO16 LYMPHOVIR Cohort

• Published in: Clinical infectious diseases 2015-11, Vol.61 (9), p.1469-1475
• Main Authors: Besson, Caroline, Lancar, Remi, Prevot, Sophie, Brice, Pauline, Meyohas, Marie-Caroline, Marchou, Bruno, Gabarre, Jean, Bonnet, Fabrice, Goujard, Cécile, Lambotte, Olivier, Boué, François, Mounier, Nicolas, Partisani, Marialuisa, Raffi, Francois, Costello, Régis, Hendel-Chavez, Houria, Algarte-Genin, Michele, Trabelsi, Selma, Marchand, Lucie, Raphael, Martine, Taoufik, Yassine, Costagliola, Dominique
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anti-Retroviral Agents - therapeutic use; Antineoplastic Agents - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Antiretroviral drugs; Antiretroviral Therapy, Highly Active - methods; Bleomycin - therapeutic use; Clinical outcomes; Dacarbazine - therapeutic use; Doxorubicin - therapeutic use; Drug therapy; Female; France; HIV; HIV Infections - complications; HIV Infections - drug therapy; Hodgkin Disease - drug therapy; Human immunodeficiency virus; Humans; Lymphoma; Male; Medical diagnosis; Middle Aged; Prognosis; Prospective Studies; Treatment Outcome; Vinblastine - therapeutic use; Young Adult
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1093/cid/civ627

Human immunodeficiency virus (HIV) infection is associated with a high risk of classical Hodgkin's lymphoma (cHL) in the combined antiretroviral therapy (cART) era. We analyzed the characteristics and outcome of HIV-associated cHL diagnosed in the modern cART era. The French ANRS-CO16 Lymphovir cohort enrolled 159 HIV-positive patients with lymphoma, including 68 (43%) with cHL. HIV-HL patients were compared with a series of non-HV-infected patients consecutively diagnosed with HL. Most patients (76%) had Ann-Arbor stages III-IV and 96% of patients were treated with ABVD. At diagnosis, median CD4 T-cell count was 387/µL and 94% of patients were treated with cART. All patients received cART after diagnosis. Five patients died from early progression (n = 2), sepsis (1) or after relapse (2). Two additional patients relapsed during follow-up. Two-year overall and progression free survivals (PFS) were 94% [95% CI, 89%, 100%] and 89% [82%, 97%], respectively. The only factor associated with progression or death was age with a relative risk of 8.1 [1.0; 67.0] above 45 years. The PFS of Lymphovir patients appeared similar to PFS of HIV-negative patients, 86% [82%, 90%], but patients with HIV infection displayed higher risk features than HIV-negative patients. Although high-risk features still predominate in HIV-HL, the prognosis of these patients, treated with cART and mainly ABVD, has markedly improved in the modern cART era and is now similar to non-HIV-infected patients.