Risk of lymphoma among people with HIV in the United States, 2001-2019.

BACKGROUND

Lymphomas are among the most common malignancies in people with HIV. Although the widespread use of combination antiretroviral therapy has substantially reduced the risk of lymphoma among people with HIV, data on specific lymphoma subtypes remain limited and outdated.

METHODS

Using data from the HIV/AIDS Cancer Match Study, a US cohort linking cancer and HIV registries and including 822 702 people with HIV, we assessed the relative risks of 14 lymphoma subtypes by calendar period and age group between 2001 and 2019. We estimated the risk of lymphoma subtypes using standardized incidence ratios (SIRs) adjusted for age, sex, race, ethnicity, and registry. Trends of standardized incidence ratios for lymphoma subtypes across calendar periods were estimated using Poisson regression overall and by age groups.

RESULTS

There were 6577 non-Hodgkin lymphoma (NHL) cases and 1783 Hodgkin lymphomas cases between 2001 and 2019. Standardized incidence ratios declined notably over time for most NHL subtypes, including diffuse large B-cell lymphoma, Burkitt lymphoma, peripheral T-cell lymphoma, central nervous system NHL, and follicular lymphoma. Between 2015 and 2019, lymphoma subtypes with elevated risk among people with HIV included diffuse large B-cell lymphoma (SIR = 5.38, 95% CI = 5.02 to 5.76), Burkitt lymphoma (SIR = 15.1, 95% CI = 12.6 to 17.9), peripheral T-cell lymphoma (SIR = 1.68, 95% CI = 1.26 to 2.20), central nervous system lymphoma (SIR = 8.85, 95% CI = 7.05 to 11.0), nodular sclerosis Hodgkin lymphoma (SIR = 4.04, 95% CI = 3.22 to 5.02), and other classic Hodgkin lymphoma (SIR = 8.99, 95% CI = 8.00 to 10.1). For most lymphoma subtypes, standardized incidence ratios for the 20- to 39-year-old-group were higher than for the 40- to 59-year-old and 60- to 84-year-old groups.

CONCLUSIONS

The risk of lymphomas among people with HIV in the United States declined between 2001 and 2019, with variations across histological subtypes and age groups. Despite overall declines, several NHL subtypes and Hodgkin lymphoma risk remained elevated, underscoring the continued lymphoma burden among people with HIV.