Epidemiological characteristics and incidence of primary central nervous system lymphoma in 80 HIV-infected patients followed from 1983 to 1999.

Objective - To describe the epidemiological characteristics of primary cent ral nervous system lymphoma (PCNSL) and the evolution of the incidence of t his lymphoma in HIV-infected patients with a more than 17-year follow-up. Results - Eighty cases of PCNSL were analyzed from a data base of 2263 AIDS subjects followed from 1983 to 1999 (3.5% of the patients with AIDS). At t he time of diagnosis, PCNSL was the first AIDS defining event in 36% of the cases, median CD4 count was 9/mm(3) (0-134); 82% of the patients were give n antiretroviral therapy (HAART = 0). Only eight cases of PCNSL were observ ed after 1996 (median HIV RNA level: 250 000 copies/mL (24 000-1 500 000)). The incidence was 39 per 100 patients-year in 1991 and decreased to 1.9 in 1999. At the end of the study, 78 patients had died (98%). The median surv ival was one month before 1996 ([0-27], n = 72), and was ten months after ( [0-44], n = 8). Two patients were still alive 38 and 44 months after diagno sis. After 1996, survival was increased in patients with good response to a ntiretroviral treatment and in patients with high CD4 count at the moment o f diagnosis. Conclusion - After the introduction of HAART (1996), the incidence of PCNSL has decreased drastically and survival was increased. (C) 2001 Editions sc ientifiques et medicales Elsevier SAS.