Hernández-Ramírez RU, et al. - In order to determine how immunosuppression and HIV viremia impact risk for non-Hodgkin lymphoma, which is common in people living with HIV, researchers investigated important CD4 count and HIV RNA (viral load) prognosticators of risk for non-Hodgkin lymphoma. From 21 Canadian and US cohorts participating in the North American AIDS Cohort Collaboration on Research and Design, they identified 102,131 people living with HIV during the study period; non-Hodgkin lymphoma developed in 712 of these people. Recent CD4 count and average viral load during a 3-year window lagged by 6 months were identified as important independent predictors of risk for overall non-Hodgkin lymphoma as well as important predictors of risk for diffuse large B-cell lymphoma. However, for CNS non-Hodgkin lymphoma risk, recent CD4 count was the single important predictor; for Burkitt lymphoma, the proportion of time viral load was greater than 500 copies per mL during the 3-year window (a cumulative measure) was the single important predictor. Findings thereby suggest that in the development of non-Hodgkin lymphoma, recent immunosuppression and prolonged HIV viremia both have imperative independent parts to play. To prevent non-Hodgkin lymphoma, they stress reducing HIV replication and B-cell activation, and reestablishing general immune function via early and continuous antiretroviral therapy.