A Single Centre Retrospective Cohort Analysis of HIV Associated Lymphoma from Northern India

The year 2024 marks the 20th year since when free cART was introduced in India. This study reports the clinicopathologic profile and outcomes of people living with HIV (PLHIV) who were diagnosed with lymphoma from Northern India. We also review the outcomes of HIV-associated lymphoma in India reported over the past 2 decades. This study included all PLHIV of age ≥ 12 years who were diagnosed with lymphoma and treated at our center between June 2009 and June 2022. Demographic profile, lymphoma subtype, stage and CD4 count at lymphoma diagnosis, and treatment outcomes were analysed. Forty-eight PLHIV patients were diagnosed with lymphoma during the study period of which 31(64.5%) were diagnosed with AIDS Defining Lymphoma (ADL) while 17 (35.4%) were diagnosed with Non-AIDS Defining Lymphoma. Extra-nodal disease was more common in ADLs as compared to NADLs (87% vs. 23%; p < 0.001). 58% (n = 28) patients were previously known HIV, 42% (n = 20) were diagnosed to have HIV concurrent with lymphoma diagnosis. DLBCL was the most common subtype, diagnosed in 45.8% patients. 79% (38/48) patients received a definitive treatment regimen for lymphoma. The median overall survival of the cohort was 26 months. 5-year OS for patients who received definitive lymphoma therapy was 55.2 ± 9%. On multivariate analysis, the receipt of lymphoma directed therapy (HR:5.6 {95% CI:1.34-23.37}, p value:0.018) and a baseline CD4 count of ≥ 200cells/µL (HR:3.5 {95% CI:1.09-11.26}, p value: 0.035) were predictors of overall survival. The lack of lymphoma-directed therapy and a CD 4 count < 200 cells/µL continue to be a significant factors negatively impacting survival in the contemporary cART era in India.

The online version contains supplementary material available at 10.1007/s12288-024-01927-3.