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. 2023 Dec 1;37(15):2331-2338.
doi: 10.1097/QAD.0000000000003700. Epub 2023 Aug 24.

Differential survival of Brazilian patients with diffuse large B-cell lymphoma with and without HIV infection

Mariana P Ferreira  1 , Luiz Claudio S Thuler  1 , Anke Bergmann  1 , Esmeralda A Soares  1 , Marcelo A Soares  2   3
Affiliations

Differential survival of Brazilian patients with diffuse large B-cell lymphoma with and without HIV infection

Mariana P Ferreira et al. AIDS. .

Abstract

Objective: Combinatorial antiretroviral therapy provided improvement of HIV patients' immune function and a decrease in the incidence of non-Hodgkin lymphoma (NHL). Diffuse large B-cell lymphoma (DLBCL) is one of the most common NHL forms affecting HIV+ patients. The present study aimed to evaluate the impact of HIV infection on the prognosis of patients treated for DLBCL in a reference cancer treatment center in Brazil.

Methods: A retrospective case-control study was developed with patients followed-up at the Brazilian National Cancer Institute, in which 243 DLBCL patients (91 HIV+ and 152 HIV-) were enrolled. HIV- controls were matched to HIV+ according to date of cancer diagnosis, clinical staging, primary cancer treatment and date of birth. Sociodemographic and cancer treatment data were extracted from medical charts. Kaplan-Meier analyses were carried out to estimate survival, while univariate and multiple Cox regression analyses were used to determine factors associated with mortality.

Results: A total of 98 deaths were observed in a 5-year period after cancer diagnosis. A negative association of HIV infection with both overall and disease-specific survival 1 year after cancer diagnosis was observed [hazard ratio (HR) = 1.98 and 1.96, respectively]. The negative association with HIV infection with disease-specific survival remained significant for a 5-year period after cancer diagnosis (HR = 1.53). HIV viral load above 1000 copies/ml at study entry was also associated with shorter overall and cancer-specific survival.

Conclusions: HIV infection negatively impacted prognosis and mortality of DLBCL patients irrespective of cancer-related clinical factors.

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