The role of HIV-1 DNA levels in HIV-related lymphoma patients treated with autologous stem cell transplantation (ASCT)

Objective. Aim of our study was to evaluate the kinetics of HIV-1 DNA levels (HIV DNA) and its clinical role in HIV-related lymphoma patients undergoing autologous stem cell transplantation (ASCT). Materials and methods. HIV DNA was measured by real-time PCR in the peripheral blood mononuclear cells (PBMCs) of 22 patients, 16 with non-Hodgkin’s lymphoma and 6 with Hodgkin’s disease. Results: Baseline HIV DNA levels were associated with HIV-1 RNA levels (HIV RNA) (r = 0.56, p = 0.02), but not with CD4 counts (r = - 0.10, p = 0.68).The viremia was undetectable for all the follow-up time post-ASCT, while HIV DNA could be evaluated in a high percentage of patients before ASCT and during the entire follow-up (median, 89.5%). At 3 months and at 1 year from transplantation, the median HIV DNA levels were 113 copies/106 PBMCs (baseline vs. 3 months, p > 0.05) and 66 copies/106 PBMCs (baseline vs. 1 year, p > 0.05), respectively. Moreover, baseline HIV DNA levels were significantly different between alive and deceased patients (p = 0.03), and the overall survival (OS) analysis showed that patients with higher HIV DNA levels at baseline had an increased and nearly significant risk of dying if compared to patients with lower levels (HR, 8.33, 95% CI, 0.99-70.06, p = 0.05). Conclusions: Our study demonstrated the association between increased HIV DNA levels at baseline and overall survival after ASCT, in one of the largest cohorts of HIV-lymphoma patients, treated with salvage therapy.