Treatment Disparity Identified in HIV-positive Black Patients With Hodgkin Lymphoma
Significant disparities have been found in HIV-positive black patients with Hodgkin lymphoma, with regard to both rate of diagnosis and chemotherapy usage.
Black patients with HIV not only have a higher risk of being diagnosed with Hodgkin lymphoma, they also are less likely to receive chemotherapy that would likely be effective.1
“Hodgkin lymphoma is generally believed to be highly curable,” said Dr. Adam Olszewski, associate professor of medicine in the Alpert Medical School of Brown University and a physician in the Cancer Center of Memorial Hospital in Pawtucket, RI.
“We have an expectation to cure over 90 percent of early stage patients and even 70-80 percent of quite advanced cases.”
Olszewski was the lead author on the study that identified the significant racial disparity. The study included data from approximately 2100 cases in the National Cancer Data Base between 2004 and 2012. While it was known that people with HIV have a 5 to 20 times greater risk of developing Hodgkin lymphoma, HIV incidence has dropped among whites. Black patients made up 49% of simultaneous HIV and Hodgkin lymphoma cases in 2012.
Results from the study showed that HIV-negative people had an 80% Hodgkin lymphoma 5-year survival rate, while HIV-positive people had a 66% rate. However, 16% of those with HIV did not receive treatment. In those who did receive treatment, death rates from Hodgkin lymphoma in those who were HIV positive were approximately equal.
Black people with HIV were 67% more likely to go untreated than whites. Possible factors could be false assumptions that HIV-positive patients won't tolerate treatment well, socioeconomic status, and being uninsured.
Olszewski said doctors should be aware that some patients “may need extra assistance or attention to ensure they connect” with the proper care.
- Racial disparity lies at intersection of HIV, Hodgkin lymphoma [news release]. EurekaAlert; January 8, 2016. http://www.eurekalert.org/pub_releases/2016-01/bu-rdl010816.php. Accessed January 11, 2016.