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 betwee...
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| Veröffentlicht in: | AIDS (London) 2013-09, Vol.27 (15), p.2365-2373 |
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| creator | Gopal, Satish Patel, Monita R. Yanik, Elizabeth L. Cole, Stephen R. Achenbach, Chad J. Napravnik, Sonia Burkholder, Greer A. Reid, Erin G. Rodriguez, Benigno Deeks, Steven G. Mayer, Kenneth H. Moore, Richard D. Kitahata, Mari M. Richards, Kristy L. Eron, Joseph J. |
| description | 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 ( |
| doi_str_mv | 10.1097/QAD.0b013e3283635232 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3773290</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1443403325</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5202-277b9d655972dce89b1215a558b3d49011701cf8d89b9babad04a5b92bd2ad433</originalsourceid><addsrcrecordid>eNqFkcFu1DAQhi0EotvCGyCUCxKXtLbHju0L0qqFtlJRhQRcrUniEIMTL3a2q317stqlFA705MN8_6_xfIS8YvSUUaPOPi0vTmlNGTjgGiqQHPgTsmBCQSmlYk_JgvLKlAYUPSLHOX-nlEqq9XNyxEFBxYRZkI_LnGPjcfJxLGJXOExhW1xdfy3ufHKDx2Ljp74YYpow-GlbYDe5tANKPCRdW4TtsOrjgC_Isw5Ddi8P7wn58uH95_Or8ub28vp8eVM2klNecqVq01ZSGsXbxmlTM84kSqlraIWhjCnKmk6388TUWGNLBcra8Lrl2AqAE_Ju37ta14ObK8YpYbCr5AdMWxvR278no-_tt3hnQSnghs4Fbw8FKf5cuzzZwefGhYCji-tsmQJpuNSGPY4KAYICcDmjYo82KeacXHe_EaN2J83O0uy_0ubY64e_uQ_9tjQDbw4A5gZDl3BsfP7DKaVBVbuz6D23iWG2lH-E9cYl2zsMU___HX4BJSmxvQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1443403325</pqid></control><display><type>article</type><title>Association of early HIV viremia with mortality after HIV-associated lymphoma</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Journals@Ovid Complete</source><creator>Gopal, Satish ; Patel, Monita R. ; Yanik, Elizabeth L. ; Cole, Stephen R. ; Achenbach, Chad J. ; Napravnik, Sonia ; Burkholder, Greer A. ; Reid, Erin G. ; Rodriguez, Benigno ; Deeks, Steven G. ; Mayer, Kenneth H. ; Moore, Richard D. ; Kitahata, Mari M. ; Richards, Kristy L. ; Eron, Joseph J.</creator><creatorcontrib>Gopal, Satish ; Patel, Monita R. ; Yanik, Elizabeth L. ; Cole, Stephen R. ; Achenbach, Chad J. ; Napravnik, Sonia ; Burkholder, Greer A. ; Reid, Erin G. ; Rodriguez, Benigno ; Deeks, Steven G. ; Mayer, Kenneth H. ; Moore, Richard D. ; Kitahata, Mari M. ; Richards, Kristy L. ; Eron, Joseph J.</creatorcontrib><description>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 (<400 copies/ml). In adjusted analyses, mortality was associated with older age [adjusted hazard ratio (AHR) 1.37 per decade increase, 95% CI 1.03–1.83], lymphoma occurrence on ART (AHR 1.63, 95% CI 1.02–2.63), lower CD4 cell count (AHR 0.75 per 100 cells/μl increase, 95% CI 0.64–0.89), and higher early cumulative viremia (AHR 1.35 per log10copies × 6-months/ml, 95% CI 1.11–1.65). The detrimental effect of early cumulative viremia was consistent across patient groups defined by ART status, CD4 cell count, and histology.
CONCLUSION:Exposure to each additional 1-unit log10 in HIV RNA throughout the 6 months after lymphoma diagnosis was associated with a 35% increase in subsequent mortality. These results suggest that early and effective ART during chemotherapy may improve survival.</description><identifier>ISSN: 0269-9370</identifier><identifier>EISSN: 1473-5571</identifier><identifier>DOI: 10.1097/QAD.0b013e3283635232</identifier><identifier>PMID: 23736149</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins, Inc</publisher><subject>Adult ; Anti-Retroviral Agents - therapeutic use ; Biological and medical sciences ; CD4 Lymphocyte Count ; Female ; Hematologic and hematopoietic diseases ; Hodgkin Disease - drug therapy ; Hodgkin Disease - mortality ; Human immunodeficiency virus ; Human viral diseases ; Humans ; Immunodeficiencies ; Immunodeficiencies. Immunoglobulinopathies ; Immunopathology ; Infectious diseases ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; Lymphoma, AIDS-Related - drug therapy ; Lymphoma, AIDS-Related - mortality ; Lymphoma, Non-Hodgkin - drug therapy ; Lymphoma, Non-Hodgkin - mortality ; Male ; Medical sciences ; Middle Aged ; Risk Factors ; RNA, Viral - blood ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; Viral Load ; Viremia - drug therapy ; Viremia - mortality</subject><ispartof>AIDS (London), 2013-09, Vol.27 (15), p.2365-2373</ispartof><rights>2013 Lippincott Williams & Wilkins, Inc.</rights><rights>2014 INIST-CNRS</rights><rights>2013 Wolters Kluwer Health | Lippincott Williams & Wilkins</rights><rights>2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5202-277b9d655972dce89b1215a558b3d49011701cf8d89b9babad04a5b92bd2ad433</citedby><cites>FETCH-LOGICAL-c5202-277b9d655972dce89b1215a558b3d49011701cf8d89b9babad04a5b92bd2ad433</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27783763$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23736149$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gopal, Satish</creatorcontrib><creatorcontrib>Patel, Monita R.</creatorcontrib><creatorcontrib>Yanik, Elizabeth L.</creatorcontrib><creatorcontrib>Cole, Stephen R.</creatorcontrib><creatorcontrib>Achenbach, Chad J.</creatorcontrib><creatorcontrib>Napravnik, Sonia</creatorcontrib><creatorcontrib>Burkholder, Greer A.</creatorcontrib><creatorcontrib>Reid, Erin G.</creatorcontrib><creatorcontrib>Rodriguez, Benigno</creatorcontrib><creatorcontrib>Deeks, Steven G.</creatorcontrib><creatorcontrib>Mayer, Kenneth H.</creatorcontrib><creatorcontrib>Moore, Richard D.</creatorcontrib><creatorcontrib>Kitahata, Mari M.</creatorcontrib><creatorcontrib>Richards, Kristy L.</creatorcontrib><creatorcontrib>Eron, Joseph J.</creatorcontrib><title>Association of early HIV viremia with mortality after HIV-associated lymphoma</title><title>AIDS (London)</title><addtitle>AIDS</addtitle><description>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 (<400 copies/ml). In adjusted analyses, mortality was associated with older age [adjusted hazard ratio (AHR) 1.37 per decade increase, 95% CI 1.03–1.83], lymphoma occurrence on ART (AHR 1.63, 95% CI 1.02–2.63), lower CD4 cell count (AHR 0.75 per 100 cells/μl increase, 95% CI 0.64–0.89), and higher early cumulative viremia (AHR 1.35 per log10copies × 6-months/ml, 95% CI 1.11–1.65). The detrimental effect of early cumulative viremia was consistent across patient groups defined by ART status, CD4 cell count, and histology.
CONCLUSION:Exposure to each additional 1-unit log10 in HIV RNA throughout the 6 months after lymphoma diagnosis was associated with a 35% increase in subsequent mortality. These results suggest that early and effective ART during chemotherapy may improve survival.</description><subject>Adult</subject><subject>Anti-Retroviral Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>CD4 Lymphocyte Count</subject><subject>Female</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Hodgkin Disease - drug therapy</subject><subject>Hodgkin Disease - mortality</subject><subject>Human immunodeficiency virus</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Immunodeficiencies</subject><subject>Immunodeficiencies. Immunoglobulinopathies</subject><subject>Immunopathology</subject><subject>Infectious diseases</subject><subject>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</subject><subject>Lymphoma, AIDS-Related - drug therapy</subject><subject>Lymphoma, AIDS-Related - mortality</subject><subject>Lymphoma, Non-Hodgkin - drug therapy</subject><subject>Lymphoma, Non-Hodgkin - mortality</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Risk Factors</subject><subject>RNA, Viral - blood</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><subject>Viral Load</subject><subject>Viremia - drug therapy</subject><subject>Viremia - mortality</subject><issn>0269-9370</issn><issn>1473-5571</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkcFu1DAQhi0EotvCGyCUCxKXtLbHju0L0qqFtlJRhQRcrUniEIMTL3a2q317stqlFA705MN8_6_xfIS8YvSUUaPOPi0vTmlNGTjgGiqQHPgTsmBCQSmlYk_JgvLKlAYUPSLHOX-nlEqq9XNyxEFBxYRZkI_LnGPjcfJxLGJXOExhW1xdfy3ufHKDx2Ljp74YYpow-GlbYDe5tANKPCRdW4TtsOrjgC_Isw5Ddi8P7wn58uH95_Or8ub28vp8eVM2klNecqVq01ZSGsXbxmlTM84kSqlraIWhjCnKmk6388TUWGNLBcra8Lrl2AqAE_Ju37ta14ObK8YpYbCr5AdMWxvR278no-_tt3hnQSnghs4Fbw8FKf5cuzzZwefGhYCji-tsmQJpuNSGPY4KAYICcDmjYo82KeacXHe_EaN2J83O0uy_0ubY64e_uQ_9tjQDbw4A5gZDl3BsfP7DKaVBVbuz6D23iWG2lH-E9cYl2zsMU___HX4BJSmxvQ</recordid><startdate>20130924</startdate><enddate>20130924</enddate><creator>Gopal, Satish</creator><creator>Patel, Monita R.</creator><creator>Yanik, Elizabeth L.</creator><creator>Cole, Stephen R.</creator><creator>Achenbach, Chad J.</creator><creator>Napravnik, Sonia</creator><creator>Burkholder, Greer A.</creator><creator>Reid, Erin G.</creator><creator>Rodriguez, Benigno</creator><creator>Deeks, Steven G.</creator><creator>Mayer, Kenneth H.</creator><creator>Moore, Richard D.</creator><creator>Kitahata, Mari M.</creator><creator>Richards, Kristy L.</creator><creator>Eron, Joseph J.</creator><general>Lippincott Williams & Wilkins, Inc</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>5PM</scope></search><sort><creationdate>20130924</creationdate><title>Association of early HIV viremia with mortality after HIV-associated lymphoma</title><author>Gopal, Satish ; Patel, Monita R. ; Yanik, Elizabeth L. ; Cole, Stephen R. ; Achenbach, Chad J. ; Napravnik, Sonia ; Burkholder, Greer A. ; Reid, Erin G. ; Rodriguez, Benigno ; Deeks, Steven G. ; Mayer, Kenneth H. ; Moore, Richard D. ; Kitahata, Mari M. ; Richards, Kristy L. ; Eron, Joseph J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5202-277b9d655972dce89b1215a558b3d49011701cf8d89b9babad04a5b92bd2ad433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Anti-Retroviral Agents - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>CD4 Lymphocyte Count</topic><topic>Female</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Hodgkin Disease - drug therapy</topic><topic>Hodgkin Disease - mortality</topic><topic>Human immunodeficiency virus</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Immunodeficiencies</topic><topic>Immunodeficiencies. Immunoglobulinopathies</topic><topic>Immunopathology</topic><topic>Infectious diseases</topic><topic>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</topic><topic>Lymphoma, AIDS-Related - drug therapy</topic><topic>Lymphoma, AIDS-Related - mortality</topic><topic>Lymphoma, Non-Hodgkin - drug therapy</topic><topic>Lymphoma, Non-Hodgkin - mortality</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Risk Factors</topic><topic>RNA, Viral - blood</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><topic>Viral Load</topic><topic>Viremia - drug therapy</topic><topic>Viremia - mortality</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gopal, Satish</creatorcontrib><creatorcontrib>Patel, Monita R.</creatorcontrib><creatorcontrib>Yanik, Elizabeth L.</creatorcontrib><creatorcontrib>Cole, Stephen R.</creatorcontrib><creatorcontrib>Achenbach, Chad J.</creatorcontrib><creatorcontrib>Napravnik, Sonia</creatorcontrib><creatorcontrib>Burkholder, Greer A.</creatorcontrib><creatorcontrib>Reid, Erin G.</creatorcontrib><creatorcontrib>Rodriguez, Benigno</creatorcontrib><creatorcontrib>Deeks, Steven G.</creatorcontrib><creatorcontrib>Mayer, Kenneth H.</creatorcontrib><creatorcontrib>Moore, Richard D.</creatorcontrib><creatorcontrib>Kitahata, Mari M.</creatorcontrib><creatorcontrib>Richards, Kristy L.</creatorcontrib><creatorcontrib>Eron, Joseph J.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>AIDS (London)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gopal, Satish</au><au>Patel, Monita R.</au><au>Yanik, Elizabeth L.</au><au>Cole, Stephen R.</au><au>Achenbach, Chad J.</au><au>Napravnik, Sonia</au><au>Burkholder, Greer A.</au><au>Reid, Erin G.</au><au>Rodriguez, Benigno</au><au>Deeks, Steven G.</au><au>Mayer, Kenneth H.</au><au>Moore, Richard D.</au><au>Kitahata, Mari M.</au><au>Richards, Kristy L.</au><au>Eron, Joseph J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of early HIV viremia with mortality after HIV-associated lymphoma</atitle><jtitle>AIDS (London)</jtitle><addtitle>AIDS</addtitle><date>2013-09-24</date><risdate>2013</risdate><volume>27</volume><issue>15</issue><spage>2365</spage><epage>2373</epage><pages>2365-2373</pages><issn>0269-9370</issn><eissn>1473-5571</eissn><abstract>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 (<400 copies/ml). In adjusted analyses, mortality was associated with older age [adjusted hazard ratio (AHR) 1.37 per decade increase, 95% CI 1.03–1.83], lymphoma occurrence on ART (AHR 1.63, 95% CI 1.02–2.63), lower CD4 cell count (AHR 0.75 per 100 cells/μl increase, 95% CI 0.64–0.89), and higher early cumulative viremia (AHR 1.35 per log10copies × 6-months/ml, 95% CI 1.11–1.65). The detrimental effect of early cumulative viremia was consistent across patient groups defined by ART status, CD4 cell count, and histology.
CONCLUSION:Exposure to each additional 1-unit log10 in HIV RNA throughout the 6 months after lymphoma diagnosis was associated with a 35% increase in subsequent mortality. These results suggest that early and effective ART during chemotherapy may improve survival.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>23736149</pmid><doi>10.1097/QAD.0b013e3283635232</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | AIDS (London), 2013-09, Vol.27 (15), p.2365-2373 |
| issn | 0269-9370 1473-5571 |
| language | eng |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Journals@Ovid Complete |
| subjects | Adult Anti-Retroviral Agents - therapeutic use Biological and medical sciences CD4 Lymphocyte Count Female Hematologic and hematopoietic diseases Hodgkin Disease - drug therapy Hodgkin Disease - mortality Human immunodeficiency virus Human viral diseases Humans Immunodeficiencies Immunodeficiencies. Immunoglobulinopathies Immunopathology Infectious diseases Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis Lymphoma, AIDS-Related - drug therapy Lymphoma, AIDS-Related - mortality Lymphoma, Non-Hodgkin - drug therapy Lymphoma, Non-Hodgkin - mortality Male Medical sciences Middle Aged Risk Factors RNA, Viral - blood Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Viral Load Viremia - drug therapy Viremia - mortality |
| title | Association of early HIV viremia with mortality after HIV-associated lymphoma |
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