Highly active antiretroviral therapy (HAART) improves survival in HIV-associated Hodgkin's disease: results of a multicenter study

Background: The purpose of the study was to evaluate the outcome of Hodgkin’s disease (HD) in patients infected with the human immunodeficiency virus (HIV) with respect to the use of highly active antiretroviral therapy (HAART). Materials and methods: This cohort study included patients with HIV-HD diagnosed from June 1984 to February 2004. Patients treated in the pre-HAART era (1984–1996) were compared with those belonging to the HAART era (1997–2004). Results: Of 66 patients with HIV-HD, 47 (71%) presented with stage III/IV disease and 38 patients (58%) with an AIDS-defining illness. Fifty-nine of 66 patients (89.4%) underwent curative intended chemotherapy. Patients receiving HAART (n = 34) had a significantly better 2-year overall survival (OS) than those not receiving HAART (74% versus 30%, P <0.001). The 2-year OS of HAART-responders was 88% compared with 19% in patients without HAARTresponse (P = 0.0002). By multivariate analysis patients without HAART had a 5.6-fold higher risk for 3-year mortality [HR 5.6, 95% confidence interval (CI) 2.20–14.26]. Three-year mortality was significantly higher in patients without complete remission (HR 4.40, CI 1.77–10.99), with stage III/IV HD (HR 4.64, CI 1.31–16.49) and with CD4 cells <200/ll (HR 2.69, CI 0.99–7.33). Conclusions: Use of HAART significantly improved the overall survival in patients with HIV-HD.