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Comparative Study
. 2024 Jul 3;24(1):796.
doi: 10.1186/s12885-024-12569-z.

A comparison of clinical profile and treatment outcome of Hodgkin's Lymphoma in Tanzania according to HIV status during the HAART era

Mercy M Mbai  1   2 , Emmanuel Mduma  3   4 , Samuel Thuo  5 , Eulade Rugengamanzi  3   6   7 , Christina V Malichewe  3 , Emmanuel L Lugina  3   8
Affiliations
Comparative Study

A comparison of clinical profile and treatment outcome of Hodgkin's Lymphoma in Tanzania according to HIV status during the HAART era

Mercy M Mbai et al. BMC Cancer. .

Abstract

Background: The incidence of Hodgkin's lymphoma (HL) in people living with HIV (PLWHA) and on HAART is approximately 20-30 times higher than in HIV-negative individuals. Most patients with HIV-HL present at an advanced stage (III-IV) have 'B' symptoms and extranodal involvement. The natural history and risk stratification of HIV-HL has undergone a significant change as a result of HAART's rollout. This study investigated the differences in clinicopathological and survival patterns of HL among individuals with and without HIV disease in Tanzania during the HAART era.

Methodology: This hospital-based retrospective cohort study was conducted at the ORCI, Dar-Es-Salaam, Tanzania. Chi-square and Fisher's exact tests were used to compare proportions. The student t-test was used to compare means. To determine factors that predict survival, we used the log-rank test to analyze the variables in univariate analysis. A Cox regression model was used to analyze the significant factors from univariate analysis in multivariate analysis.

Results: Eighty-three patients with HL were recruited, and the prevalence of HIV-positive status was 27.7%. Most of the patients with HIV-HL had an age of > 30 years (73.9%), while most of the non-HIV-HL patients had an age of ≤ 30 years (63.3%) (P = 0.02). The 2-year OS rate for HIV-HL was 34%, while that for non-HIV-HL was 67%. Among the HIV-HL patients, predictors of a poorer outcome were a CD4 count ≤ 200 cells/mm3 (P = 0.05), lack of HAART use (P = 0.00), and the use of HAART for ≤ 10 months (P = 0.00).

Conclusion: The prevalence of HIV-HL was 27.7% among HL patients. HIV positivity is still a poor prognostic factor in our setting, especially for patients not on HAART, on HAART for ≤ 10 months, or with a low CD4 count below 200 cells/mm3. Patients with HIV-HL were older and had higher LDH levels, whereas patients with non-HIV-HL were younger and had low LDH levels.

Keywords: Clinical profile; HIV; Hodgkin’s Lymphoma; Overall survival; Predictors of survival.

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Conflict of interest statement

The authors declare no competing interests.

Figures

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A flowchart describing the selection of patients
Fig. 1
Fig. 1
The comparison of OS between HIV-HL and non-HIV = HL
Fig. 2
Fig. 2
The association between OS and CD4 count (cells/mm3)
Fig. 3
Fig. 3
The association between the use of HAART and OS among patients with HIV-HL
Fig. 4
Fig. 4
The association between HAART use duration and OS among HIV-HL patients
See this image and copyright information in PMC

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