Increased Incidence of Hodgkin Disease in Homosexual Men with HIV Infection

Abstract

To evaluate the incidence of Hodgkin disease and non-Hodgkin lymphoma among homosexual men infected with human immunodeficiency virus (HIV). Cohort study with computer-matched identification of participants with the Northern California Cancer Center registry. Population rate comparisons were made with data from the Surveillance, Epidemiology, and End Results (SEER) cancer registry. The 6704 homosexual men in the San Francisco City Clinic Cohort study. Incidence of Hodgkin disease, non-Hodgkin lymphoma, HIV infection, and the acquired immunodeficiency syndrome (AIDS); calculation of sex and age-adjusted standardized morbidity ratios and attributable risk. Eight cases of Hodgkin disease and 90 cases of non-Hodgkin lymphoma were identified through computer matching among cohort members residing in the San Francisco Bay area from 1978 through 1989. Among the HIV-infected men, the age-adjusted standardized morbidity ratio was 5.0 (95% CI, 2.0 to 10.3) for Hodgkin disease and 37.7 (CI, 30.3 to 46.7) for non-Hodgkin lymphoma. The excess risk attributable to HIV infection was 19.3 cases of Hodgkin disease per 100,000 person-years and 224.9 cases of non-Hodgkin lymphoma per 100,000 person-years. An excess incidence of Hodgkin disease was found in HIV-infected homosexual men. Additional well-designed epidemiologic studies are needed to determine whether Hodgkin disease should be considered an HIV-related malignancy.