Strong impact of highly active antiretroviral therapy on survival in patients with human immunodeficiency virus‐associated Hodgkin's disease

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Abstract
Summary: Hodgkin's disease (HD) is the most common non‐acquired immunodeficiency syndrome (AIDS)‐defining malignancy in human immunodeficiency virus (HIV)‐infected patients. We analysed the outcome of patients with HIV‐associated HD (HIV‐HD) with respect to the use and efficacy of highly active antiretroviral therapy (HAART) and other prognostic factors. To evaluate the effects of several variables on overall survival (OS), Kaplan–Meier statistics and extended Cox regression analysis were performed. Response to HAART was used as a time‐dependent variable and was defined as an increase of >0·1 × 109 CD4 cells/l and/or at least one viral load <500 copies/ml during the first 2 years following diagnosis of HIV‐HD. Fifty‐seven patients with HIV‐HD diagnosed between 1990 and 2002 were included in the study. In the Cox model, the only factors independently associated with OS were HAART response [relative hazard (RH) 0·19; 95% confidence interval (CI) 0·06–0·60], complete remission (RH 0·30, 95% CI 0·13–0·72), and age 45 years (RH 0·23; 95% CI 0·09–0·60). Median survival time in patients without HAART response was 18·6 months, whereas the median survival time in patients with HAART response was not reached (89% OS at 24 months). In this cohort, a significant improvement in survival was found in patients with HIV‐HD who responded to HAART.

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