Trimodal or bimodal age-specific incidence rates for Burkitt lymphoma (BL) were observed in the United States general population, but the role of immunosuppression could not be excluded. Incidence rates, rate ratios, and 95% confidence intervals for BL and other non-Hodgkin lymphoma (NHL), by age and CD4 lymphocyte count categories, were estimated using Poisson regression models using data from the United States HIV/AIDS Cancer Match study . BL incidence was 22 cases per 100 000 person-years and 586 for non-BL NHL. Adjusted BL incidence rate ratio among males was 1.6؋ that among females and among non-Hispanic blacks, 0.4؋ that among non-Hispanic whites, but unrelated to HIV-transmission category. Non-BL NHL incidence increased from childhood to adulthood; in contrast, 2 age-specific incidence peaks during the pediatric and adult/geriatric years were observed for BL. Non-BL NHL incidence rose steadily with decreasing CD4 lymphocyte counts; in contrast, BL incidence IntroductionBurkitt lymphoma (BL) is an aggressive B-cell non-Hodgkin lymphoma (NHL) with 3 clinical variants: endemic (eBL), sporadic (sBL), and acquired immunodeficiency-associated BL (aBL). 1 These clinical variants, which are defined in part by where they occur geographically, are histologically indistinguishable 1 and their etiology is incompletely understood. 2 eBL occurs in children mostly as extranodal jaw or orbital masses in equatorial Africa and Papua New Guinea. 3 sBL occurs anywhere in the world at any age mostly with abdominal or nodal involvement. [4][5] Immunodeficiencyassociated BL is diagnosed in people with HIV, 1 among whom it is often the first indication of AIDS onset at least in the West. Risk for both eBL and sBL appears to be highest at ages 5-9 years and sBL rates are also elevated at the oldest ages. 4,6 Because BL is a rapidly growing tumor, doubling its cell mass approximately every 1-2 days, 7 the interval from trigger to diagnosis may be relatively short, so study of age-specific risk may provide etiologic information.In an assessment of age-specific risk for BL in the United States, using data from the National Cancer Institute Surveillance, Epidemiology, and End Results Program (1973-2005), 8 we observed 3 incidence peaks near ages 10, 40, and 70 years among males and 2 peaks near ages 10 and 70 years among females for both whites and blacks. However, the role of AIDS-related immunosuppression could not be excluded 9,10 because we were not able to separately analyze AIDS and non-AIDS BL. To address this limitation, we investigated age-specific BL incidence among persons with AIDS (PWA) in the United States Because age is a surrogate for cumulative exposure to deleterious infections a linear increase in risk for BL with age in PWA would suggest cumulative impact of deleterious infections given immunosuppression, whereas a nonlinear risk increase would suggest that age may be a surrogate for differences in the etiology or biology of BL diagnosed at different ages that occur independent of immunosuppression. 8 MethodsData...

Squamous cell carcinoma of the conjunctiva (SCCC) has been associated with HIV infection in equatorial Africa, but the evidence for association with HIV in developed countries, where SCCC is rarer, is controversial. We investigated the risk for SCCC and other eye cancers in the updated U.S. HIV/AIDS Cancer Match Registry Study. We calculated standardized incidence ratios (SIRs) to estimate excess risk for SCCC, primary ocular lymphoma, ocular Kaposi sarcoma (KS) and other eye tumors among 491, 048 adults (aged > 15 years or older) with HIV/AIDS diagnosed from 1980 to 2004. We calculated relative proportions (per 10 5) to gain insight into risk factors. We identified 73 eye cancers (15 SCCC, 35 primary ocular lymphoma, 17 ocular KS and 6 other). Overall SIRs were elevated for SCCC (SIR, 12.2, 95% CI 6.8-20.2), primary ocular lymphoma (21.7, 95% CI 15.1-30.2) and ocular KS (109, 95% CI 63.5-175). Risk for SCCC was elevated regardless of HIV acquisition category, CD4 lymphocyte count and time relative to AIDS-onset. Relative proportions of SCCC risk were highest with age ≥50 (8/10 5), Hispanic ethnicity (7/10 5) and residence in regions with high-solar ultraviolet radiation (10/ 10 5). We show significantly increased incidence of SCCC among persons with HIV/AIDS in the U.S. The associations with age and geography are in accord with etiological role for ultraviolet radiation in SCCC.

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The role of protective immunity to Plasmodium falciparum (Pf) malaria in Burkitt lymphoma (BL) is unknown. We investigated the association between BL and antibodies reactive to SE36 antigen, a recombinant protein based on Pf-SERA5 gene, targeted by protective malaria immune responses. Cases were children (0–14 years) enrolled at the Korle-Bu Teaching Hospital, Accra, Ghana, during 1965–1994 with BL confirmed by histology or cytology (92% of cases). Controls were healthy appearing children enrolled contemporaneous to the cases from the nearest neighbor house to the case house age- and sex-frequency matched to the cases. Anti-SE36 IgG antibodies were measured using enzyme-linked absorbent immunoassays (ELISA). SE36 titers were estimated by extrapolating ELISA optical density (OD) readings to a standard fitting curve. Anti-SE36 titers were log-transformed for analysis. Odds ratios (OR) and 2-sided 95% confidence intervals (95% CI) were estimated using unconditional logistic regression. The mean log endpoint dilution titers were 0.63 logs lower in cases than in controls (8.26 [SD 1.68] versus 8.89 [SD 1.75], Student’s t-test, P=0.019). Lower titers were observed in cases than controls aged 0–4 years (P=0.05) and in those aged 5–14 years (P=0.06). Low and medium tertiles of anti-SE36 IgG antibodies were associated with increased OR for BL ([OR 1.67, 95% CI 1.21–2.31] and [OR 1.33, 95% CI 0.96– 1.86], respectively, Ptrend =0.002) in analyses adjusting for age, sex, calendar period, and test plate. Our findings suggest that compared to similarly aged children enrolled from the same community, children with BL in Ghana have lower antibodies to SE36 antigen.

Kaposi sarcoma-associated herpesvirus (KSHV, also called Human herpesvirus 8 or HHV8) is a γ-2 herpesvirus that causes Kaposi sarcoma. KSHV seroprevalence rates vary geographically with variable rates recorded in different sub Sahara African countries, suggesting that effects of genetic and/or environmental factors may influence the risk of infection. One study conducted in South Africa, where KSHV seroprevalence is relatively low, found that carriage of human leukocyte antigen (HLA) alleles HLA-A*6801, HLA-A*30, HLA-A*4301, and HLA-DRB1*04 was associated with increased shedding of KSHV DNA in saliva. Confirmation of those results would strengthen the hypothesis that genetic factors may influence KSHV distribution by modulating KSHV shedding in saliva. To explore these associations in another setting, we used high resolution HLA-A, B, and DRB1 typing on residual samples from the Uganda Sickle Cell Anemia KSHV study, conducted in a high KSHV seroprevalence region, to investigate associations between HLA and KSHV shedding in saliva or peripheral blood among 233 children and their mothers. HLA-A and HLA-DRB1 alleles were not associated with KSHV shedding in our study, but our study was small and was not adequately powered to exclude small associations. In exploratory analyses, we found marginal association of KSHV DNA shedding in saliva but not in peripheral blood among children carrying HLA- B*4415 and marginal association of KSHV DNA shedding in peripheral blood but not in saliva among children carrying HLA- B*0801 alleles. The contribution of individual HLA polymorphisms to KSHV shedding is important but it may vary in different populations. Larger population-based studies are needed to estimate the magnitude and direction of association of HLA with KSHV shedding and viral control.

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Background: There have been suggestions of an association between Chlamydia pneumoniae, chlamydial heat shock protein (Ch-hsp) 60 and human heat shock protein (h-hsp) 60 infection sero-status and development of secondary cardiovascular events. Patients with diabetes might be at higher risk since they are prone to infections. The objective of this study was to investigate prospectively the role of Chlamydia pneumoniae (CP), chlamydial heat shock protein (Ch-hsp) 60 and a possible intermediate role of human heat shock protein (h-hsp) 60 sero-status in the development of secondary cardiovascular disease (CVD) events in patients with coronary heart disease (CHD) under special consideration of diabetes mellitus.

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