Treatment for HIV, Lymphoma Varies Among Racial Groups

Several factors influence survival among patients with both HIV and Hodgkin’s lymphoma.

A recent study found there is a difference in the likelihood of treatment between races among HIV-positive patients with Hodgkin’s lymphoma.

Patients infected with HIV have a 5 to 20 times greater risk of getting Hodgkin’s lymphoma, than those who are HIV-negative.

When conducting the study, researchers looked at data from 2100 cases between 2004 and 2012. They originally knew HIV rates were still relatively high among blacks and had a significant decrease for whites. The results also showed blacks surpassed whites in being infected with both HIV and Hodgkin’s lymphoma.

In the past, there has been conflicting opinions on whether or not patients with HIV and Hodgkin’s lymphoma are able to survive as long as patients with just Hodgkin’s lymphoma. Some patients with an HIV infection aren’t able to tolerate the lymphoma regime, however, in recent years chemotherapy has greatly improved.

There have also been studies performed in Europe that showed HIV infections do affect survival rates in Hodgkin’s lymphoma patients, as opposed to in the United States, where it is believed that having HIV gives less of a chance of survival.

The current study found that those who have both HIV and cancer are less likely to get treated in the United States, which is why these patients have inferior survival rates.

The 5-year survival rate of HIV-negative patients with Hodgkin’s lymphoma after diagnosis was about 80%. Meanwhile, HIV-positive patients had a 5-year survival rate of 66%. Of the patients with HIV, only 16% were left untreated.

Among HIV-positive patients treated for lymphoma, researchers found this group was just as likely to survive as those who did not carry the HIV infection.

After researchers made some adjustments, it was reported that HIV-positive black patients were 67% more likely to go untreated for lymphoma than HIV-positive whites.

"Black patients have higher rates of not receiving treatment," said lead author Adam Olszewski, MD. "Hodgkin’s lymphoma is generally believed to be highly curable. We have an expectation to cure over 90% of early stage patients and even 70% to 80% of quite advanced cases.”

Some other risk factors included low income, no health insurance, or being aged over 60 years.

Although racial disparities are unclear, there is some speculation associated with more advanced HIV infection, HIV that is poorly controlled, and patients who won’t tolerate the treatment well.

Another factor suggested are that patients decline treatment for HIV, lymphoma or both, making them more susceptible and vulnerable. Economic status could also play a role with patients who are black, poor, and uninsured, which makes it extremely difficult to get the care they need.

Dr. Olszewski stresses that HIV-positive and Hodgkin’s lymphoma patients are able to receive effective and tolerant treatment, but that physicians need to keep in mind that some patients might need additional assistance and attention in order to get the care they need.