HIV-Associated Hodgkin Lymphoma in African-Americans
Krishna M Irrinki, Olaide Ajayi, Lisa Fitzpatrick, Anita Aggarwal, Lekidelu Taddesse-Heath. Howard University Hospital and College of Medicine, Washington, DC
Background: The risk of developing Hodgkin lymphoma (HL) is 10 fold higher in HIV infected patients (HIV+) compared to the general population. The incidence of HIV-associated non-Hodgkin lymphoma (NHL) has declined since the advent of combined antiretroviral therapy. In contrast, several studies have shown that the incidence of HIV-associated HL has increased with higher median CD4 counts seen in HL compared to NHL and more prevalence of the nodular sclerosis subtype with higher CD4 counts. We reviewed HIV-associated HL in a predominantly African-American patient population to compare these observations.
Design: We retrospectively reviewed consecutive lymphoma cases diagnosed at our institution between 2004 and 2010. Demographic data, CD4 count and clinical stage were obtained from the medical records. Hematoxylin and eosin and immunohistochemical stained slides were reviewed and in situ hybridization studies for Epstein-Barr virus (EBV) were performed.
Results: There were 174 patients with lymphoma with 17% (30) HL and 83% (144) NHL. Of these 21% (37/174) were HIV+ with 22% (8/37) HL and 78% (29/37) NHL. There were a total of 30 patients with HL all of whom were African-Americans. Of these 27% (8/30) were HIV+ with a median age of 41 years. The male to female ratio in the HIV+HL was 3:1 compared to 1:1.3 in the non-HIV HL. The median time from HIV diagnosis to development of HL was 17 years. In the HIV+ HL, the median CD4 count was 265 compared to 101 in the HIV+NHL patients. 88% of the HIV+ HL had advanced stage disease with 63% stage IV and 25% stage III. Nodular sclerosis (50%) and mixed cellularity (38%) were the most common subtypes and all cases were positive for EBV.
Conclusions: Our study demonstrates that HIV-associated HL in African-Americans have a male predominance, higher mean CD4 count compared to NHL, advanced stage disease, and a predominance of nodular sclerosis and mixed cellularity subtypes. These observations are similar to those reported in the literature in the general population.
Wednesday, March 21, 2012 9:30 AM
Poster Session V # 201, Wednesday Morning