%0 Journal Article
%T Survival and Prognostic Factors for AIDS and Non-AIDS Patients with Non-Hodgkin¡¯s Lymphoma in Bahia, Brazil: A Retrospective Cohort Study
%A Estela Luz
%A Marinho Marques
%A Ivana Luz
%A Cristiani Stelitano
%A Eduardo Netto
%A Iguaracyra Ara¨²jo
%A Carlos Brites
%J ISRN Hematology
%D 2013
%R 10.1155/2013/904201
%X Despite the benefits of HAART, HIV-infected patients are increasingly affected by different malignancies. We compared a 5-year-period survival time and prognostic factors for HIV-1-infected individuals diagnosed with non-Hodgkin lymphomas (NHL) in a nested case-control study, with non-HIV-infected individuals in Salvador, Brazil. Survival time and prognostic factors were compared to HIV-negative patients. 31 cases (versus 63 controls) had a significantly more advanced NHL at diagnosis and lower mean CD4 count (26£¿cells/mm3) than controls. Mean overall survival (OS) was 35.8 versus 75.4 months, for cases and controls, respectively ( ), while mean event-free survival time (EFS) was 34.5 months for cases, versus 68.8 for controls ( ). Higher IPI, increased LDH levels, bone marrow infiltration, lower absolute lymphocyte counts (<1,000£¿cells/mm3), and type B symptoms were associated with a shorter survival time for cases. Although patients without poorer prognostic factors at baseline had an OS comparable to controls, the mean CD4 cell count for cases was similar for patients with favorable and nonfavorable response to therapy. Our findings suggest that HIV-1 infection is significantly associated with a shorter survival time for patients with NHL, independently of other predictive factors and of disease stage. 1. Introduction The main characteristic of AIDS is a severe immunodeficiency caused by the progressive depletion of CD4+ T-cells and consequent immune impairment [1]. These facts ultimately lead to an increasing risk of developing opportunistic infections and malignancies [2, 3]. Non-Hodgkin lymphoma (NHL) is an AIDS-defining condition, and its frequency seems to be decreasing after the highly active antiretroviral therapy (HAART) became the standard of care for the management of AIDS patients [4, 5]. HAART has promoted a great increase in the lifespan of HIV-infected patients and decreased the morbidity and mortality caused by AIDS [6]. However, the available evidence suggests that around half of the patients treated are unable to reach a normal CD4+ cell count, even after years of persistent viral suppression. One of the reasons for such findings is the persistent immune activation, but its causative mechanisms are still a matter of debate [7]. These facts may be responsible for the persistence of a higher risk for the development of other malignancies, a trend recently detected in treated AIDS patients, as a likely consequence of incomplete immune restoration. While there is a clear trend toward reducing AIDS-defining events (which include Kaposi¡¯s
%U http://www.hindawi.com/journals/isrn.hematology/2013/904201/