![]() Univariate and multivariate conditional logistic regression models were used. For this second analysis, controls were selected among HIV-positive men who had also developed AIDS and were matched by time since AIDS diagnosis.ĭemographic characteristics were examined in cases and controls using chi square tests for categorical variables and a test of medians for continuous variables. A second nested case–control analysis was performed among only cases who developed NHL after developing AIDS. Serum for the time point closest to diagnosis was evaluated for each participant, which included samples available from within 1 year before diagnosis in 45% of cases and 57% of controls. The questionnaires and protocols used in the MACS have been approved by the appropriate Institutional Review Boards, and informed consent was received for all participants.įor each participant, KSHV DNA was tested in stored serum from up to three time points before the date of NHL diagnosis: within 1 year, between 1.1 and 3 years, and between 3.1 and 5 years before diagnosis. Each NHL case was individually matched by year of first HIV-positive visit (within 1 year) and duration of HIV infection at the time of NHL diagnosis to a HIV-positive man who did not develop NHL and had banked serum available. 14, 16, 17 Cases with sufficient banked serum available to perform viral DNA analyses in the 5 years before lymphoma diagnosis were studied. 15 The MACS is a multicenter cohort of HIV-infected and uninfected MSM that includes semiannual visits. We performed a nested case–control study of HIV-positive NHL cases identified within the Multicenter AIDS Cohort Study (MACS) between 19. We investigated the association of KSHV DNA and KSHV antibodies with NHL risk within a well-established cohort of HIV-positive MSM. 13 KSHV DNA in serum is a more specific marker of KSHV infection. However, KSHV serologic testing has limited sensitivity and specificity. 9, 10 However, initial studies did not identify an association between antibodies to KSHV and NHL risk in pre- 11 or postdiagnostic 12 NHL serum. ![]() 6, 8 Several studies have suggested a broader relationship between KSHV infection and AIDS-related NHL beyond that known for the clinically distinctive primary effusion lymphomas. 6 The prevalence of KSHV antibodies is low in the general US population (0–8%) but elevated in patients with HIV, particularly in men who have sex with men (MSM 25–50%). KSHV was originally discovered in studies of patients with Kaposi sarcoma (KS) and subsequently recognized to be associated with a rare subset of NHL, often presenting as lymphomatous effusions (primary effusion lymphoma). ![]() 4, 5 Like Epstein-Barr virus (EBV), Kaposi sarcoma herpes virus (KSHV, also known as HHV8) is a B-cell-tropic virus thought to cause of a subset of AIDS-related NHL. 1, 2 The incidence of NHL in HIV-infected individuals has decreased with the introduction of effective antiretroviral therapy 3 but remains elevated above the background incidence. Aggressive B-cell non-Hodgkin lymphoma (NHL) is the second most common cancer associated with HIV and is an AIDS-defining illness. ![]()
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