Association of early HIV viremia with mortality after HIV-associated lymphoma

OBJECTIVE:To examine the association between early HIV viremia and mortality after HIV-associated lymphoma. DESIGN:Multicenter observational cohort study. SETTING:Center for AIDS Research Network of Integrated Clinical Systems cohort. PARTICIPANTS:HIV-infected patients with lymphoma diagnosed between 1996 and 2011, who were alive 6 months after lymphoma diagnosis and with at least two HIV RNA values during the 6 months after lymphoma diagnosis. EXPOSURE:Cumulative HIV viremia during the 6 months after lymphoma diagnosis, expressed as viremia copy-6-months. MAIN OUTCOME MEASURE:All-cause mortality between 6 months and 5 years after lymphoma diagnosis. RESULTS:Of 224 included patients, 183 (82%) had non-Hodgkin lymphoma (NHL) and 41 (18%) had Hodgkin lymphoma. At lymphoma diagnosis, 105 (47%) patients were on antiretroviral therapy (ART), median CD4 cell count was 148 cells/μl (interquartile range 54–322), and 33% had suppressed HIV RNA (