Childhood exposure to simian virus 40‐contaminated poliovirus vaccine and risk of AIDS‐associated non‐Hodgkin's lymphoma

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Abstract
Persons with acquired immunodeficiency syndrome (AIDS) have increased risk for non‐Hodgkin's lymphoma (NHL). Recent studies have reported the detection of DNA sequences from simian virus 40 (SV40), a macaque polyomavirus that contaminated early poliovirus vaccines, in a large proportion of AIDS‐associated NHLs. To examine the association between SV40 exposure and NHL risk, we analyzed data from a U.S. registry‐based cohort study of persons with AIDS (1980–96). We calculated NHL incidence in persons born in 1958–61 (exposed to SV40‐contaminated poliovirus vaccine as children, n = 39,468) and in 1964–67 (born after vaccines were cleared of SV40 and thus unexposed, n = 17,340). Among persons with AIDS, NHL incidence was 11.7 per 1,000 person‐years in SV40‐exposed individuals (616 NHL cases) and 10.1 per 1,000 person‐years in SV40‐unexposed individuals (230 cases; unadjusted relative risk 1.15, 95% CI 0.99–1.34, p = 0.06). Because of differences in cohorts' birth years and the evolving demographics of the AIDS epidemic, SV40‐exposed subjects were older at AIDS onset than unexposed subjects (mean age 32.0 vs. 27.2 years, p < 0.0001), and the cohorts differed by sex (p < 0.0001) and ethnic group (p < 0.0001). Since NHL incidence was relatively high among whites (p < 0.0001) and homosexual males (p < 0.0001) and increased with age (p = 0.09), comparisons required adjustments for these factors. After adjustment, SV40 exposure was not associated with NHL incidence (adjusted relative risk 0.97, 95% CI 0.79–1.20, p = 0.80). We conclude that childhood exposure to SV40 through receipt of contaminated poliovirus vaccine was not associated with increased risk for AIDS‐associated NHL. Our findings do not support a role for SV40 in lymphomagenesis among immunosuppressed persons.