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Viral co-infections and paraproteins in HIV: effect on development of hematological malignancies

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Abstract

The role of viral co-infections and paraproteins in the development of hematological malignancies (HMs) in HIV remains unclear. Using our large database of HIV+ patients, we investigated whether co-infection and paraproteinemia increase the risk of HM. Data on demographics, hepatitis B (HBV) and hepatitis C virus (HCV) co-infections, paraproteinemia, HIV characteristics, and biopsy proven malignant hematological disorders for HIV+ patients were collected over a 10-year period in a large urban hospital setting. We identified 10,293 HIV+ patients who were followed for a median duration of 53 months. Of the 10,293 patients with HIV, 229 (2.2 %) were diagnosed with a HM. Over 85 % of patients in both groups were tested; no significant difference in the prevalence of chronic HBV or HCV was noted between the HM positive (n = 229) and HM negative (n = 9992) patients. The serum protein electrophoresis test was performed for 1371 of the 10,221 patients. HM positive patients, compared to HM negative, were more likely to be tested for paraproteins (OR 3.3, 95 % CI 2.5–4.4) and more likely to have a discrete paraprotein band (OR 3.3, 95 % CI 1.2–8.9). Discrete paraproteins exclusively correlated with the development of plasma cell malignancies. Faint or oligoclonal protein bands were seen in high grade B cell lymphomas but did not show a significant correlation with HM development. Chronic hepatitis B or C infections did not correlate with the development of HM in HIV; however, viral influence on host gene transformation may have been impacted by anti-viral therapy limiting the duration of high viremic states.

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Acknowledgments

We would like to sincerely thank Dr. Jacob Rand, Ms. Mojgan Raoufi, and Ms. Irene Ostrowsky for their support in interpreting the laboratory data. We acknowledge Dr. Eran Bellin for his development of Clinical Looking Glass and his staff for their support in data retrieval. We also thank the Einstein Montefiore Center for AIDS Research (NIH AI-051519) for their support of the cohort development.

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Authors and Affiliations

  1. Division of Hematology, Department of Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA

    Erin Jou, Oleg Gligich & Henny H. Billett

  2. Partner State Key Laboratory of Oncology in South China, Sir Y K Pao Centre for Cancer, Department of Clinical Oncology, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong

    Alvita C. Y. Chan, Edwin P. Hui, Anthony T. C. Chan & Radha Raghupathy

  3. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Diwakar Mohan

  4. Division of Infectious Diseases, Department of Internal Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA

    Uriel R. Felsen

  5. Department of Hematology and Oncology, University Hospitals Case Medical Center, Cleveland, OH, USA

    Sabarish Ayyappan

Authors
  1. Erin Jou
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  2. Oleg Gligich
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  3. Alvita C. Y. Chan
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  6. Sabarish Ayyappan
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  7. Henny H. Billett
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  8. Edwin P. Hui
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  9. Anthony T. C. Chan
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  10. Radha Raghupathy
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Corresponding author

Correspondence to Radha Raghupathy.

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Montefiore Medical Center institutional review board approved the study.

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The authors of the manuscript have no conflict of interest to declare.

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Key Points

1. Discrete paraproteinemia is a risk factor for the development of hematological malignancies in HIV and exclusively correlates with the development of plasma cell neoplasms.

2. Co-infection with hepatitis B or hepatitis C does not appear to confer additional risk of hematological malignancies.

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Jou, E., Gligich, O., Chan, A.C.Y. et al. Viral co-infections and paraproteins in HIV: effect on development of hematological malignancies. Ann Hematol 95, 575–580 (2016). https://doi.org/10.1007/s00277-016-2588-z

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  • DOI: https://doi.org/10.1007/s00277-016-2588-z

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