The risk of Hodgkin lymphoma (HL) is increased in patients infected with
HIV-1. We studied the incidence and outcomes of HL, and compared CD4(+)
T-cell trajectories in HL patients and controls matched for duration of
combination antiretroviral therapy (cART). A total of 40 168 adult
HIV-1-infected patients (median age, 36 years; 70% male; median CD4
cell count, 234 cells/mu L) from 16 European cohorts were observed
during 159 133 person-years; 78 patients developed HL. The incidence was
49.0 (95% confidence interval [CI], 39.3-61.2) per 100 000
person-years, and similar on cART and not on cART (P=.96). The risk of
HL declined as the most recent (time-updated) CD4 count increased: the
adjusted hazard ratio comparing more than 350 with less than 50 cells/mu
L was 0.27 (95% CI, 0.08-0.86). Sixty-oneHLcases diagnosed on cART were
matched to 1652 controls: during the year before diagnosis, cases lost
98 CD4 cells (95% CI, -159 to -36 cells), whereas controls gained 35
cells (95% CI, 24-46 cells; P<.0001). The incidence of HL is not
reduced by cART, and patients whose CD4 cell counts decline despite
suppression of HIV-1 replication on cART may harbor HL. (Blood.
2011;117(23):6100-6108
