Risk of lymphomas among people with HIV in the United States during 2001-2019

Abstract

Introduction Lymphomas are among the most common malignancies in people with HIV (PWH). Although the widespread use of combination antiretroviral therapy has significantly reduced the risk of lymphoma among PWH, data on specific lymphoma subtypes remain limited and outdated. Methods Using data from the HIV/AIDS Cancer Match Study, a U.S. cohort linking cancer and HIV registries and including 822,702 PWH, we assessed the relative risks of 14 lymphoma subtypes by calendar period and age group during 2001-2019. We estimated the risk of lymphoma subtypes using standardized incidence ratios (SIRs) adjusted for age, sex, race, ethnicity, and registry. Trends of SIRs for lymphoma subtypes across calendar periods were estimated using Poisson regression overall and by age groups. Results There were 6,577 non-Hodgkin lymphomas (NHL) and 1,783 Hodgkin lymphomas (HL) during 2001-2019. SIRs declined significantly over time for most NHL subtypes including diffuse large B-cell lymphoma (DLBCL), Burkitt lymphoma (BL), peripheral T-cell lymphoma (PTCL), central nervous system (CNS) NHL, and follicular lymphoma. During 2015-2019, lymphoma subtypes with elevated risk among PWH included DLBCL (SIR = 5.38, 95%CI = 5.02-5.76), BL (15.1, 12.6-17.9), PTCL (1.68, 1.26-2.20), CNS lymphoma (8.85, 7.05-11.0), nodular sclerosis HL (4.04, 3.22-5.02), and other classical HL (8.99, 8.00-10.1). For most lymphoma subtypes, SIRs for the 20-39-year-old-group were higher than 40-59-year-old and 60-84-year-old groups. Conclusion The risk of lymphomas among PWH in the US declined during 2001-2019, with variations across histological subtypes and age groups. Despite overall declines, several NHL subtypes and HL risk remained elevated recently, underscoring the continued lymphoma burden among PWH.