- citati u SCIndeksu: 0
- citati u CrossRef-u:0
- citati u Google Scholaru:[
 ]
- posete u poslednjih 30 dana:2
- preuzimanja u poslednjih 30 dana:1
|
|
|
2020, vol. 73, br. 1-2, str. 37-42
|
|
Ne-Hočkinov limfom kod ljudi koji žive sa sindromom stečene imunodeficijencije
Non-Hodgkin lymphoma in people living with human immunodeficiency syndrome
aUniverzitet u Novom Sadu, Medicinski fakultet + Klinički centar Vojvodine, Klinika za infektivne bolesti, Novi Sad bUniverzitet u Novom Sadu, Medicinski fakultet + Klinički centar Vojvodine, Klinika za hematologiju, Novi Sad cUniverzitet u Novom Sadu, Medicinski fakultet, Zavod za farmakologiju, toksikologiju i kliničku farmakologiju
e-adresa: vanja.andric@mf.uns.ac.rs
Sažetak
Uvod. Uprkos uvođenju kombinovane antiretrovirusne terapije, stopa smrtnosti kod pacijenata sa infekcijom virusom humane imunodeficijencije i dalje je visoka, naročito ukoliko imaju istovremeno dijagnostikovano maligno oboljenje, a posebno ne-Hočkinov limfom. Cilj ovog istraživanja bio je da se utvrdi učestalost ne-Hočkinovog limfoma kod pacijenata pozitivnih na virus humane imunodeficijencije, njihove kliničke karakteristike i smrtnost u odnosu na pacijente bez ne-Hočkinovog limfoma. Materijal i metode. Retrospektivna studija je obuhvatila 396 ispitanika sa potvrđenom infekcijom virusom humane imunodeficijencije. Uvidom u medicinsku dokumentaciju, analizirane su prosečne godine života, prosečna dužina trajanja infekcije i terapije, broj nCD4+ T-limfocita, broj virusnih kopija, kao i broj i vrsta malignih oboljenja. Rezultati. Prosečna starost pacijenata u našoj studiji iznosila je 42,2 godine, a prosečan broj nCD4+ T-limfocita 296,94 ćelija/µL, dok je stopa smrtnosti bila 14,65%. Vodeći uzroci smrti su bili ne-Hočkinov limfom i sindrom stečene imunodeficijencije. Najučestaliji malignitet bio je takođe ne-Hočkinov limfom, pri čemu je prosečna vrednost nCD4+ T-limfocita u ovoj grupi iznosila 162,29 ćelija/µL. Pokazana je statistički značajno manja vrednost nCD4+ T-limfocita u grupi pacijenata sa infekcijom virusom humane imunodeficijencije i ne-Hočkinovim limfomom u odnosu na pacijente koji su imali samo virus humane imunodeficijencije, pri čemu je smrtnost u ovoj grupi iznosila 85%. Zaključak. Ne-Hočkinov limfom kod pacijenata sa infekcijom virusom humane imunodeficijencije predstavlja sve veći problem, s obzirom na visoku stopu smrtnosti. Budući da su broj nCD4+ T-limfocita i kasna dijagnoza infekcije virusom humane imunodeficijencije najveći faktori rizika za razvoj ne-Hočkinovog limfoma, neophodno je povećati obim testiranja na virus humane imunodeficijencije, te pronaći adekvatniji pristup u lečenju ovih pacijenata.
Abstract
Introduction. Even in the era of combined antiretroviral therapy, the mortality rate in patients with human immunodeficiency virus infection remains high, especially with a contributing diagnosis of a malignant disease, such as non-Hodgkin lymphoma. Given the previous, the goal of this research was to establish the incidence of non-Hodgkin lymphoma in human immunodeficiency virus positive patients, as well as to determine their clinical characteristics and mortality in regard to patients with human immunodeficiency virus only. Material and Methods. The retrospective study included 396 human immunodeficiency virus-positive patients. Medical records were reviewed to analyze the average age, duration of infection, average duration of therapy, nCD4+ T-cell count, human immunodeficiency virus viral load, as well as the number and types of malignant diseases. Results. The average age of the patients was 44.2 years; the average nCD4+ T-cell count was 296.94 cells/µL, while the mortality rate was 14.65%. The leading causes of death were non-Hodgkin lymphoma and acquired immunodeficiency syndrome. The most frequently diagnosed malignancy was non-Hodgkin lymphoma, where the average count of nCD4+ T-cells was 162.29 cells/µL. Patients with human immunodeficiency virus and non-Hodgkin lymphoma had significantly lower nCD4+ T-cell count, in regard to patients with human immunodeficiency virus only, and the mortality rate in this group of patients was 85%. Conclusion. The incidence of non-Hodgkin lymphoma in human immunodeficiency virus-positive patients represents a growing threat, given the exceptionally high mortality. The nCD4+ T-cell count may indicate acquired immunodeficiency syndrome and late diagnosis of human immunodeficiency virus together are predictors for non-Hodgkin lymphoma and its poor outcome. It points to the importance of increasing the scope of human immunodeficiency virus testing, as well as finding a better treatment approach.
|
|
|
|
Reference
|
|
 
|
Aydin, O.A., Gunduz, A.T., Sargin, F., Mete, B., Karaosmanoglu, H.K., Sevgi, D.Y., et al. (In press) Prevalence and mortality of cancer among HIV/ AIDS patients: A large-scale cohort study in Turkey. East Mediterr Health J.
|
|
|
Besson, C., Lancar, R., Prevot, S., Algarte-Genin, M., Delobel, P., Bonnet, F., Meyohas, M., Partisani, M., Oberic, L., Gabarre, J., Goujard, C., Boue, F., Coppo, P., Costello, R., Hendel-Chavez, H. (2017) Outcomes for HIV-associated diffuse large B-cell lymphoma in the modern combined antiretroviral therapy era. AIDS, 31(18): 2493-2501
|
|
|
Bijker, R., Jiamsakul, A., Uy, E., Kumarasamy, N., Ditango, R., Chaiwarith, R., et al. (2019) Cardiovascular disease-related mortality and factors associated with cardiovascular events in the TREAT Asia HIV Observational Database (TAHOD). HIV Med., 20(3):183-91
|
|
|
Camoni, L., Raimondo, M., Regine, V., Salfa, M.C., Suligoi, B. (2013) Late presenters among persons with a new HIV diagnosis in Italy: 2010-2011. BMC Public Health, 13:281
|
|
|
dalla Pria, A., Bower, M. (2018) AIDS-related malignant disease. Med., 46(6):365-9
|
|
|
Dolcetti, R., Gloghini, A., Caruso, A., Carbone, A. (2016) A lymphomagenic role for HIV beyond immune suppression?. Blood, 127(11): 1403-1409
|
|
|
European AIDS Clinical Society (EACS) (2019) Guidelines v10.0. November [monograph on the Internet], https://www.eacsociety.org/files/2019_guidelines-10.0_final.pdf [cited 2020 Feb 9]
|
|
|
Gingo, M.R., Nouraie, M., Kessinger, C.J., Greenblatt, R.M., Huang, L., Kleerup, E.C., Kingsley, L., Mcmahon, D.K., Morris, A. (2018) Decreased lung function and all-cause mortality in HIV-infected individuals. Annals of the American Thoracic Society, 15(2): 192-199
|
|
|
Hentrich, M., Wyen, C., Gillor, D., Mueller, M., Stoehr, A., Schultze, A., et al. (2016) Lymphoma-associated mortality in the German HIV-lymphoma cohort study. J Clin Oncol., 34(15 Suppl):7550
|
|
|
Howlader, N., Shiels, M.S., Mariotto, A.B., Engels, E.A. (2016) Contributions of HIV to non-Hodgkin lymphoma mortality trends in the United States. Cancer Epidemiology Biomarkers & Prevention, 25(9): 1289-1296
|
|
|
Jasra, S., Kazemi, M., Cole, D., Acuna-Villaorduna, A., Mantzaris, I., Shastri, A., Derman, O., Kornblum, N., Braunschweig, I., Verma, A., Janakiram, M. (2018) Causes and predictors of early mortality in HIV-positive and HIV-negative patients with diffuse large B-cell lymphoma. Blood, 132(Supplement 1): 1713-1713
|
|
|
Kaida, A., Gormley, R., Webster, K., Carter, A., Nicholson, V., Wang, L., et al. (2018) High mortality among women living with HIV enrolled in Canada's largest community-based cohort study. J Int AIDS Soc., 21:75
|
|
|
Menon, M., Coghill, A., Mutyaba, I., Okuku, F., Phipps, W., Harlan, J., et al. (2018) Whom to treat?: Factors associated with chemotherapy recommendations and outcomes among patients with NHL at the Uganda Cancer Institute. PloS One, 13(2):e0191967
|
|
|
Mojumdar, K., Vajpayee, M., Chauhan, N.K., Mendiratta, S. (2010) Late presenters to HIV care and treatment, identification of associated risk factors in HIV-1 infected Indian population. BMC Public Health, 10:416
|
|
|
Olszewski, A.J., Castillo, J.J. (2016) Outcomes of HIV-associated Hodgkin lymphoma in the era of antiretroviral therapy. AIDS, 30(5): 787-796
|
|
|
Oprea, C., Ianache, I., Ionescu, P., Ceausu, E., Calistru, P. (2017) Malignancies in HIV-infected patients: Incidence and predictors of survival in a Romanian health care facility. Romanian Journal of Legal Medicine, 25(2):227-34
|
|
|
Pang, W., Shang, P., Li, Q., Xu, J., Bi, L., Zhong, J., et al. (2018) Prevalence of opportunistic infections and causes of death among hospitalized HIV-infected patients in Sichuan, China. Tohoku J Exp Med., 244(3):231-42
|
|
|
Poorolajal, J., Hooshmand, E., Mahjub, H., Esmailnasab, N., Jenabi, E. (2016) Survival rate of AIDS disease and mortality in HIV-infected patients: A meta-analysis. Public Health, 139: 3-12
|
|
|
Rabkin, C.S., Goedert, J.J. (2017) Chronic hepatitis and non-Hodgkin lymphoma among people with HIV: Implications for screening, treatment, and prevention. Ann Intern Med., 166(1):69-70
|
|
|
Ramaswami, R., Pria, A., Roe, J., Nelson, M., Gazzard, B., Bower, M., et al. (2016) Evolution of HIV-associated lymphoma over three decades. HIV Med., 17(Suppl 1):44
|
|
|
Rohner, E., Bütikofer, L., Schmidlin, K., Sengayi, M., Maskew, M., Giggy, J., et al. (2018) Non-Hodgkin lymphoma risk in adults living with HIV across five continents. AIDS, 32(18): 2777-2786
|
|
|
Shiels, M.S., Engels, E.A. (2017) Evolving epidemiology of HIV-associated malignancies. Current Opinion in HIV and AIDS, 12(1): 6-11
|
|
|
Sigel, K., Park, L., Justice, A. (2019) HIV and cancer in the Veterans Health Administration System. Seminars in Oncology, 46(4-5): 334-340
|
|
|
Thrift, A.P., Chiao, E.Y. (2018) Are non-HIV malignancies increased in the HIV-infected population?. Curr Infect Dis Rep., 20(8):22
|
|
|
Totonchy, J., Cesarman, E. (2016) Does persistent HIV replication explain continued lymphoma incidence in the era of effective antiretroviral therapy?. Curr Opin Virol., 20:71-7
|
|
|
|
|