NON-HODGKINS-LYMPHOMA IN HIV-POSITIVE AND HIV-NEGATIVE HOMOSEXUAL MENIN THE SAN-FRANCISCO BAY AREA - ALLERGIES, PRIOR MEDICATION USE, AND SEXUAL PRACTICES

Lifestyle, sexual history, and medical history characteristics were an alyzed as risk factors for non-Hodgkin's lymphoma (NHL) in a populatio n-based case-control study of 1593 subjects with NHL and 2515 control subjects conducted in the San Francisco Bay Area between 1988 and 1995 . The results for homosexual men, 312 with NHL and 420 control subject s, showed that HIV infection was associated with a 20-fold increased r isk for NHL. Among HIV-positive homosexual men, after adjustment for o ther factors, those that were associated with a reduced risk for NHL w ere frequency of receptive anal intercourse between the ages of 20 and 29 (1 to 9 times: OR = 0.63; greater than or equal to 10 times: OR = 0.37; trend: p = 0.02), allergy to grass, hay, leaves, plants and poll en (OR = 0.35, CI = 0.19 to 0.64), number of bee or wasp stings (1 to 3 times: OR = 0.65; greater than or equal to 4 times: OR = 0.56; trend : p = 0.07), use of Tagamet (cimetidine) for 4 consecutive weeks or lo nger (OR = 0.39, CI = 0.17 to 0.89), vaccination against influenza (OR = 0.41, CI = 0.23 to 0.74), and lifetime frequency of amphetamine use (1 to 19 times: OR = 0.59; greater than or equal to 20 times: OR = 0. 38; trend: p = 0.003). Among HIV-negative homosexual men, after adjust ment for other factors, factors that were associated with NHL status w ere frequency of receptive anal intercourse between the ages of 20 and 29 (1 to 9 times: OR = 0.39; greater than or equal to 10 times: OR = 0.20; trend: p = 0.001), nonmedication allergies (OR = 0.43, CI = 0.21 to 0.89), vaccination against poliomyelitis at <10 years (OR = 0.41, CI. = 0.17 to 0.99), and having five or more siblings (OR = 3.6, CI = 1.7 to 7.7). An increased immunosuppressive effect of seminal fluid on sensitive rectal tissue and support from earlier work suggesting that HIV-related lymphomas may be outgrowths of antigen-driven B cells pro vide a possible mechanism for the results of this study. The role of a llergic reactions in NHL is likely to be complex and may be related to B-cell differentiation. These associations may provide insight into a n antigen-driven process early in lymphomagenesis.