Estimates of global, regional, and national incidence of Hodgkin lymphoma attributable to Human Immunodeficiency virus: A population attributable modeling study

Hodgkin lymphoma (HL) is one of the prevalent non-acquired immunodeficiency syndrome (AIDS)-related tumors in people living with human immunodeficiency virus (PLWH). This study investigates the risk of HL among PLWH and the global incidence of HL associated with human immunodeficiency virus (HIV). A meta-analysis was conducted to examine the association between HIV infection and HL, utilizing HIV prevalence data from Joint United Nations Programme on HIV/AIDS and pooled relative risk (RR) to calculate the population attributable fraction. Additionally, the age-standardized incidence rate (ASIR) of HIV-associated HL and the estimated annual percentage change (EAPC) were calculated. The findings indicated that PLWH had an increased risk of HL (pooled RR = 11.51, 95% confidence interval: 8.90, 14.89). Globally, 6.07% of new HL cases in 2019 were attributable to HIV, representing a 2.84-fold increase from 1990. The global ASIR for HIV-associated HL per 100,000 population also increased 2.25-fold from 1990 to 2019. Regionally, 41.13% of incident HL cases were attributed to HIV infection in Eastern and Southern Africa. The most notable upward trend was observed in Eastern Europe and Central Asia (EAPC 20.04%). From 1990 to 2019, 83.58% (112/134) of countries exhibited an increasing trend in HIV-associated HL ASIR, with the majority of countries showing the highest increases located in Eastern Europe, Central Asia, and the Asia-Pacific region. This study highlights the need for targeted HIV prevention policies and interventions to reduce the disease burden of HL. The limited number of studies from low- and middle-income regions, along with heterogeneity across studies, may hinder precise estimations of disease risk and burden.