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Sir—In their recent article, Fong et al. [1] report that long-term administration of high-dose acyclovir may protect against development of AIDS-related non-Hodgkin's lymphoma (NHL). We recently examined this hypothesis in a case-control study of 219 patients with AIDS-NHL and 219 HIV-positive controls, matched for degree of immune deficiency, in Sydney, Australia [2]. Our results, in a study with >7 times as many cases as studied by Fong et al., showed no relationship between acyclovir use and risk of NHL. The same percentage of case and control subjects (5.5%) had received high-dose acyclovir (mean daily dose, ⩾800 mg) during the 1-year period prior to NHL diagnosis or match date, and at lower doses there was no relationship between dose received and NHL risk. Receipt of ganciclovir in the year prior to diagnosis was nonsignificantly protective (odds ratio [OR], 0.51; 95% confidence interval [CI], 0.20–1.25). In further unpublished analyses, we found that 44% of cases and 36% of controls had received any acyclovir during the year prior to diagnosis (P = .08). There was no significant association between acyclovir or ganciclovir use and the risk of individual NHL subtypes (immunoblastic, Burkitt's, or primary CNS lymphoma).

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