5c3d32d4eb4f6c6b597cbef0932171fb cancers-13-04366-v3.pdf fd0ae58366da56150f3ed9b50dc228b48577d5da cancers-13-04366-v3.pdf 2b1fbe8554ec1bf52732d2f589f73940e196aa18af961f3521c7087c9086e882 cancers-13-04366-v3.pdf Title: Hodgkin Lymphoma in People Living with HIV Subject: Despite widespread use of combined antiretroviral therapy (cART) and increased life expectancy in people living with HIV (PLWH), HIV-related lymphomas (HRL) remain a leading cause of cancer morbidity and mortality for PLWH, even in patients optimally treated with cART. While the incidence of aggressive forms of non-Hodgkin lymphoma decreased after the advent of cART, incidence of Hodgkin lymphoma (HL) has increased among PLWH in recent decades. The coinfection of Epstein–Barr virus plays a crucial role in the pathogenesis of HL in the HIV setting. Currently, PLWH with HRL, including HL, are treated similarly to HIV-negative patients and, importantly, the prognosis of HL in PLWH is approaching that of the general population. In this regard, effective cART during chemotherapy is strongly recommended since it has been shown to improve survival rates in all lymphoma subtypes, including HL. As a consequence, interdisciplinary collaboration between HIV specialists and hemato-oncologists for the management of potential drug–drug interactions and overlapping toxicities between antiretroviral and antineoplastic drugs is crucial for the optimal treatment of PLWH with HL. In this article the authors review and update the epidemiological, clinical and biological aspects of HL presenting in PLWH with special emphasis on advances in prognosis and the factors that have contributed to it. Keywords: HIV; hodgkin lymphoma; antiretroviral therapy; prognosis Author: Jose-Tomas Navarro, José Moltó, Gustavo Tapia and Josep-Maria Ribera Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Wed Sep 1 11:10:45 2021 CEST ModDate: Wed Sep 1 11:16:40 2021 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 15 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1534452 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- BBAXXJ+VnURWPalladioL Type 1 Custom yes yes no 10 0 QIIMWQ+URWPalladioL-Ital Type 1 Custom yes yes no 15 0 TUJSXS+URWPalladioL-Bold Type 1 Custom yes yes no 20 0 JHKLDW+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 HJOMHV+VnURWPalladioL-Bold Type 1 Custom yes yes no 28 0 LCJEVJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 37 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 54 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 58 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 62 0 DVCMRV+CMSY10 Type 1 Builtin yes yes no 74 0 AYXMDM+EURM10 Type 1 Builtin yes yes no 78 0 CFJLCM+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 95 0 CFJLCO+PalatinoLinotype TrueType WinAnsi yes yes no 98 0 CFJLDA+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 101 0 XIRVNA+EURB10 Type 1 Builtin yes yes no 109 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-06-29 02:30:10 CEST RepresentationInformation: cancers-13-04366-v3.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2023-01-31 15:57:47 CET Size: 1534452 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 528 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@44c8afef Item: Title: Epidemiology Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Item: Title: Etiopathogenesis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Item: Title: Pathological and Clinical Characteristics Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: Treatment and Prognosis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: Management of cART in Patients with Classical Hodgkin Lymphoma Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Children: Item: Title: Initiation/Maintenance of cART Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Item: Title: Drug Interactions between cART and Chemotherapy Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: Clinical Approach to Management of Patients on cART and Hodgkin Lymphoma Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Info: Title: Hodgkin Lymphoma in People Living with HIV Author: Jose-Tomas Navarro, José Moltó, Gustavo Tapia and Josep-Maria Ribera Subject: Despite widespread use of combined antiretroviral therapy (cART) and increased life expectancy in people living with HIV (PLWH), HIV-related lymphomas (HRL) remain a leading cause of cancer morbidity and mortality for PLWH, even in patients optimally treated with cART. While the incidence of aggressive forms of non-Hodgkin lymphoma decreased after the advent of cART, incidence of Hodgkin lymphoma (HL) has increased among PLWH in recent decades. The coinfection of Epstein Barr virus plays a crucial role in the pathogenesis of HL in the HIV setting. Currently, PLWH with HRL, including HL, are treated similarly to HIV-negative patients and, importantly, the prognosis of HL in PLWH is approaching that of the general population. In this regard, effective cART during chemotherapy is strongly recommended since it has been shown to improve survival rates in all lymphoma subtypes, including HL. As a consequence, interdisciplinary collaboration between HIV specialists and hemato-oncologists for the management of potential drug drug interactions and overlapping toxicities between antiretroviral and antineoplastic drugs is crucial for the optimal treatment of PLWH with HL. In this article the authors review and update the epidemiological, clinical and biological aspects of HL presenting in PLWH with special emphasis on advances in prognosis and the factors that have contributed to it. Keywords: HIV; hodgkin lymphoma; antiretroviral therapy; prognosis Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Wed Sep 01 11:10:45 CEST 2021 ModDate: Wed Sep 01 11:16:40 CEST 2021 ID: 0x4ea15a1445080a96cc5212676e7e657d, 0x4ea15a1445080a96cc5212676e7e657d Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: TUJSXS+URWPalladioL-Bold FontSubset: true FirstChar: 3 LastChar: 122 FontDescriptor: FontName: TUJSXS+URWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: JHKLDW+URWPalladioL-Roma FontSubset: true FirstChar: 2 LastChar: 252 FontDescriptor: FontName: JHKLDW+URWPalladioL-Roma Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: BBAXXJ+VnURWPalladioL FontSubset: true FirstChar: 129 LastChar: 226 FontDescriptor: FontName: BBAXXJ+VnURWPalladioL Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: DVCMRV+CMSY10 FontSubset: true FirstChar: 2 LastChar: 2 FontDescriptor: FontName: DVCMRV+CMSY10 Flags: Symbolic FontBBox: -29, -960, 1116, 775 FontFile: true Font: BaseFont: HJOMHV+VnURWPalladioL-Bold FontSubset: true FirstChar: 178 LastChar: 226 FontDescriptor: FontName: HJOMHV+VnURWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: XIRVNA+EURB10 FontSubset: true FirstChar: 22 LastChar: 22 FontDescriptor: FontName: XIRVNA+EURB10 Flags: Symbolic FontBBox: -30, -247, 1178, 723 FontFile: true Font: BaseFont: AYXMDM+EURM10 FontSubset: true FirstChar: 20 LastChar: 22 FontDescriptor: FontName: AYXMDM+EURM10 Flags: Symbolic FontBBox: -32, -243, 1060, 720 FontFile: true Font: BaseFont: QIIMWQ+URWPalladioL-Ital FontSubset: true FirstChar: 2 LastChar: 121 FontDescriptor: FontName: QIIMWQ+URWPalladioL-Ital Flags: Symbolic FontBBox: -170, -305, 1010, 941 FontFile: true EncodingDictionary: Differences: true Pages: Page: Sequence: 1 Annotations: Annotation: Subtype: Link Rect: 35, 759, 153, 795 Annotation: Subtype: Link Rect: 515, 759, 560, 795 Annotation: Subtype: Link Rect: 123, 346, 154, 355 Annotation: Subtype: Link Rect: 35, 334, 140, 343 Annotation: Subtype: Link Rect: 35, 162, 97, 184 Annotation: Subtype: Link Rect: 153, 89, 154, 98 Annotation: Subtype: Link Rect: 35, 77, 147, 86 Annotation: Subtype: Link Rect: 324, 105, 331, 114 ActionDest: 125 Annotation: Subtype: Link Rect: 332, 105, 339, 114 ActionDest: 125 Annotation: Subtype: Link Rect: 396, 80, 403, 89 ActionDest: 125 Annotation: Subtype: Link Rect: 114, 17, 265, 28 Annotation: Subtype: Link Rect: 408, 17, 558, 28 Annotation: Subtype: Link Rect: 35, 399, 87, 418 Page: Sequence: 2 Annotations: Annotation: Subtype: Link Rect: 255, 661, 262, 670 ActionDest: 125 Annotation: Subtype: Link Rect: 263, 661, 270, 670 ActionDest: 125 Annotation: Subtype: Link Rect: 270, 661, 277, 670 ActionDest: 125 Annotation: Subtype: Link Rect: 212, 624, 219, 633 ActionDest: 125 Annotation: Subtype: Link Rect: 222, 624, 229, 633 ActionDest: 128 Annotation: Subtype: Link Rect: 355, 598, 367, 608 ActionDest: 128 Annotation: Subtype: Link Rect: 281, 561, 293, 570 ActionDest: 128 Annotation: Subtype: Link Rect: 293, 561, 305, 570 ActionDest: 128 Annotation: Subtype: Link Rect: 336, 536, 348, 545 ActionDest: 128 Annotation: Subtype: Link Rect: 348, 536, 360, 545 ActionDest: 128 Annotation: Subtype: Link Rect: 280, 498, 287, 507 ActionDest: 128 Annotation: Subtype: Link Rect: 288, 498, 300, 507 ActionDest: 128 Annotation: Subtype: Link Rect: 446, 473, 458, 482 ActionDest: 128 Annotation: Subtype: Link Rect: 461, 473, 473, 482 ActionDest: 128 Annotation: Subtype: Link Rect: 514, 360, 521, 369 ActionDest: 125 Annotation: Subtype: Link Rect: 521, 360, 533, 369 ActionDest: 128 Annotation: Subtype: Link Rect: 439, 322, 451, 331 ActionDest: 128 Annotation: Subtype: Link Rect: 290, 310, 302, 319 ActionDest: 128 Annotation: Subtype: Link Rect: 215, 272, 222, 281 ActionDest: 125 Annotation: Subtype: Link Rect: 222, 272, 234, 281 ActionDest: 128 Annotation: Subtype: Link Rect: 235, 272, 247, 281 ActionDest: 128 Annotation: Subtype: Link Rect: 483, 247, 495, 256 ActionDest: 128 Annotation: Subtype: Link Rect: 269, 222, 281, 231 ActionDest: 128 Annotation: Subtype: Link Rect: 281, 222, 293, 231 ActionDest: 128 Annotation: Subtype: Link Rect: 474, 197, 481, 206 ActionDest: 125 Annotation: Subtype: Link Rect: 481, 197, 493, 206 ActionDest: 128 Annotation: Subtype: Link Rect: 375, 146, 386, 155 ActionDest: 128 Annotation: Subtype: Link Rect: 387, 146, 399, 155 ActionDest: 128 Annotation: Subtype: Link Rect: 400, 146, 411, 155 ActionDest: 128 Annotation: Subtype: Link Rect: 272, 83, 284, 93 ActionDest: 128 Annotation: Subtype: Link Rect: 521, 71, 533, 80 ActionDest: 128 Annotation: Subtype: Link Rect: 533, 71, 545, 80 ActionDest: 128 Page: Sequence: 3 Annotations: Annotation: Subtype: Link Rect: 276, 694, 288, 703 ActionDest: 132 Annotation: Subtype: Link Rect: 357, 657, 369, 666 ActionDest: 128 Annotation: Subtype: Link Rect: 497, 631, 509, 640 ActionDest: 132 Annotation: Subtype: Link Rect: 533, 594, 545, 603 ActionDest: 132 Annotation: Subtype: Link Rect: 462, 556, 474, 565 ActionDest: 132 Annotation: Subtype: Link Rect: 477, 556, 489, 565 ActionDest: 132 Annotation: Subtype: Link Rect: 277, 531, 289, 540 ActionDest: 128 Annotation: Subtype: Link Rect: 227, 519, 239, 527 ActionDest: 128 Annotation: Subtype: Link Rect: 500, 506, 512, 515 ActionDest: 132 Annotation: Subtype: Link Rect: 513, 506, 525, 515 ActionDest: 132 Annotation: Subtype: Link Rect: 520, 481, 532, 490 ActionDest: 132 Annotation: Subtype: Link Rect: 479, 468, 491, 477 ActionDest: 132 Annotation: Subtype: Link Rect: 492, 468, 504, 477 ActionDest: 132 Annotation: Subtype: Link Rect: 504, 468, 516, 477 ActionDest: 132 Annotation: Subtype: Link Rect: 299, 443, 311, 452 ActionDest: 132 Annotation: Subtype: Link Rect: 314, 443, 326, 452 ActionDest: 132 Annotation: Subtype: Link Rect: 361, 430, 373, 440 ActionDest: 132 Annotation: Subtype: Link Rect: 374, 430, 386, 440 ActionDest: 132 Annotation: Subtype: Link Rect: 529, 406, 540, 414 ActionDest: 132 Annotation: Subtype: Link Rect: 531, 343, 543, 352 ActionDest: 128 Annotation: Subtype: Link Rect: 544, 343, 556, 352 ActionDest: 128 Annotation: Subtype: Link Rect: 454, 317, 466, 327 ActionDest: 132 Annotation: Subtype: Link Rect: 467, 317, 479, 327 ActionDest: 132 Annotation: Subtype: Link Rect: 343, 292, 355, 301 ActionDest: 132 Annotation: Subtype: Link Rect: 358, 292, 370, 301 ActionDest: 132 Annotation: Subtype: Link Rect: 447, 280, 459, 289 ActionDest: 132 Annotation: Subtype: Link Rect: 460, 280, 472, 289 ActionDest: 135 Annotation: Subtype: Link Rect: 544, 267, 556, 276 ActionDest: 132 Annotation: Subtype: Link Rect: 441, 242, 453, 251 ActionDest: 128 Annotation: Subtype: Link Rect: 530, 217, 541, 226 ActionDest: 135 Annotation: Subtype: Link Rect: 544, 217, 556, 226 ActionDest: 135 Annotation: Subtype: Link Rect: 327, 192, 339, 201 ActionDest: 135 Annotation: Subtype: Link Rect: 339, 192, 351, 201 ActionDest: 135 Annotation: Subtype: Link Rect: 191, 167, 203, 176 ActionDest: 135 Annotation: Subtype: Link Rect: 204, 167, 216, 176 ActionDest: 135 Annotation: Subtype: Link Rect: 423, 129, 435, 138 ActionDest: 135 Annotation: Subtype: Link Rect: 544, 104, 556, 113 ActionDest: 135 Annotation: Subtype: Link Rect: 502, 66, 514, 76 ActionDest: 135 Annotation: Subtype: Link Rect: 514, 66, 526, 76 ActionDest: 135 Page: Sequence: 4 Annotations: Annotation: Subtype: Link Rect: 504, 722, 516, 731 ActionDest: 128 Annotation: Subtype: Link Rect: 365, 685, 377, 694 ActionDest: 128 Annotation: Subtype: Link Rect: 222, 659, 234, 669 ActionDest: 135 Annotation: Subtype: Link Rect: 237, 659, 249, 669 ActionDest: 135 Annotation: Subtype: Link Rect: 194, 634, 206, 643 ActionDest: 128 Annotation: Subtype: Link Rect: 368, 597, 379, 606 ActionDest: 135 Annotation: Subtype: Link Rect: 380, 597, 392, 606 ActionDest: 135 Annotation: Subtype: Link Rect: 500, 458, 512, 467 ActionDest: 135 Annotation: Subtype: Link Rect: 260, 433, 267, 442 ActionDest: 125 Annotation: Subtype: Link Rect: 267, 433, 274, 442 ActionDest: 128 Annotation: Subtype: Link Rect: 275, 433, 287, 442 ActionDest: 135 Annotation: Subtype: Link Rect: 259, 358, 271, 367 ActionDest: 128 Annotation: Subtype: Link Rect: 315, 345, 327, 354 ActionDest: 128 Annotation: Subtype: Link Rect: 328, 345, 340, 354 ActionDest: 128 Annotation: Subtype: Link Rect: 340, 345, 352, 354 ActionDest: 135 Annotation: Subtype: Link Rect: 265, 330, 272, 342 ActionDest: 85 Page: Sequence: 5 Annotations: Annotation: Subtype: Link Rect: 397, 722, 409, 731 ActionDest: 128 Annotation: Subtype: Link Rect: 264, 685, 276, 694 ActionDest: 135 Annotation: Subtype: Link Rect: 509, 659, 521, 669 ActionDest: 135 Annotation: Subtype: Link Rect: 521, 659, 533, 669 ActionDest: 135 Annotation: Subtype: Link Rect: 534, 659, 546, 669 ActionDest: 135 Annotation: Subtype: Link Rect: 202, 622, 214, 631 ActionDest: 128 Annotation: Subtype: Link Rect: 215, 622, 227, 631 ActionDest: 128 Annotation: Subtype: Link Rect: 227, 597, 234, 606 ActionDest: 128 Annotation: Subtype: Link Rect: 235, 597, 247, 606 ActionDest: 128 Annotation: Subtype: Link Rect: 247, 597, 259, 606 ActionDest: 128 Annotation: Subtype: Link Rect: 256, 584, 268, 593 ActionDest: 128 Annotation: Subtype: Link Rect: 329, 572, 341, 581 ActionDest: 135 Annotation: Subtype: Link Rect: 341, 572, 353, 581 ActionDest: 135 Annotation: Subtype: Link Rect: 357, 559, 364, 568 ActionDest: 125 Annotation: Subtype: Link Rect: 364, 559, 371, 568 ActionDest: 128 Annotation: Subtype: Link Rect: 372, 559, 384, 568 ActionDest: 128 Annotation: Subtype: Link Rect: 417, 556, 424, 570 ActionDest: 106 Annotation: Subtype: Link Rect: 83, 492, 93, 499 ActionDest: 135 Annotation: Subtype: Link Rect: 72, 468, 82, 475 ActionDest: 135 Annotation: Subtype: Link Rect: 86, 454, 92, 461 ActionDest: 125 Annotation: Subtype: Link Rect: 72, 430, 82, 437 ActionDest: 128 Annotation: Subtype: Link Rect: 60, 397, 70, 404 ActionDest: 135 Annotation: Subtype: Link Rect: 73, 363, 83, 371 ActionDest: 135 Annotation: Subtype: Link Rect: 72, 340, 82, 347 ActionDest: 128 Annotation: Subtype: Link Rect: 75, 316, 81, 324 ActionDest: 128 Annotation: Subtype: Link Rect: 386, 129, 393, 138 ActionDest: 125 Annotation: Subtype: Link Rect: 393, 129, 400, 138 ActionDest: 128 Annotation: Subtype: Link Rect: 401, 129, 413, 138 ActionDest: 128 Annotation: Subtype: Link Rect: 413, 129, 425, 138 ActionDest: 135 Annotation: Subtype: Link Rect: 206, 91, 213, 100 ActionDest: 128 Annotation: Subtype: Link Rect: 213, 91, 225, 100 ActionDest: 128 Annotation: Subtype: Link Rect: 226, 91, 238, 100 ActionDest: 128 Annotation: Subtype: Link Rect: 238, 91, 250, 100 ActionDest: 135 Annotation: Subtype: Link Rect: 251, 91, 263, 100 ActionDest: 135 Annotation: Subtype: Link Rect: 453, 66, 460, 75 ActionDest: 125 Page: Sequence: 6 Annotations: Annotation: Subtype: Link Rect: 456, 685, 462, 694 ActionDest: 125 Annotation: Subtype: Link Rect: 463, 685, 470, 694 ActionDest: 128 Annotation: Subtype: Link Rect: 470, 685, 482, 694 ActionDest: 128 Annotation: Subtype: Link Rect: 483, 685, 495, 694 ActionDest: 135 Annotation: Subtype: Link Rect: 498, 685, 510, 694 ActionDest: 135 Annotation: Subtype: Link Rect: 544, 647, 556, 656 ActionDest: 128 Annotation: Subtype: Link Rect: 269, 622, 281, 631 ActionDest: 128 Annotation: Subtype: Link Rect: 429, 534, 441, 543 ActionDest: 135 Annotation: Subtype: Link Rect: 435, 459, 447, 468 ActionDest: 135 Annotation: Subtype: Link Rect: 507, 409, 519, 417 ActionDest: 135 Annotation: Subtype: Link Rect: 440, 371, 447, 380 ActionDest: 125 Annotation: Subtype: Link Rect: 448, 371, 459, 380 ActionDest: 128 Annotation: Subtype: Link Rect: 495, 368, 502, 380 ActionDest: 106 Annotation: Subtype: Link Rect: 348, 283, 360, 292 ActionDest: 138 Annotation: Subtype: Link Rect: 345, 258, 357, 267 ActionDest: 138 Annotation: Subtype: Link Rect: 223, 170, 235, 179 ActionDest: 138 Annotation: Subtype: Link Rect: 502, 82, 514, 91 ActionDest: 138 Page: Sequence: 7 Annotations: Annotation: Subtype: Link Rect: 529, 697, 541, 706 ActionDest: 138 Annotation: Subtype: Link Rect: 544, 697, 556, 706 ActionDest: 138 Annotation: Subtype: Link Rect: 204, 659, 216, 669 ActionDest: 138 Annotation: Subtype: Link Rect: 408, 609, 420, 618 ActionDest: 138 Annotation: Subtype: Link Rect: 420, 609, 432, 618 ActionDest: 138 Annotation: Subtype: Link Rect: 346, 521, 358, 530 ActionDest: 128 Annotation: Subtype: Link Rect: 359, 521, 371, 530 ActionDest: 138 Annotation: Subtype: Link Rect: 279, 496, 291, 505 ActionDest: 128 Annotation: Subtype: Link Rect: 292, 496, 304, 505 ActionDest: 128 Annotation: Subtype: Link Rect: 304, 496, 316, 505 ActionDest: 138 Annotation: Subtype: Link Rect: 419, 471, 431, 480 ActionDest: 138 Annotation: Subtype: Link Rect: 434, 471, 446, 480 ActionDest: 138 Annotation: Subtype: Link Rect: 508, 433, 520, 442 ActionDest: 138 Annotation: Subtype: Link Rect: 520, 433, 532, 442 ActionDest: 138 Annotation: Subtype: Link Rect: 442, 344, 454, 353 ActionDest: 138 Annotation: Subtype: Link Rect: 455, 344, 467, 353 ActionDest: 138 Annotation: Subtype: Link Rect: 203, 319, 215, 328 ActionDest: 138 Annotation: Subtype: Link Rect: 218, 319, 230, 328 ActionDest: 141 Annotation: Subtype: Link Rect: 285, 294, 297, 303 ActionDest: 141 Annotation: Subtype: Link Rect: 442, 281, 459, 290 ActionDest: 141 Annotation: Subtype: Link Rect: 191, 256, 208, 265 ActionDest: 141 Annotation: Subtype: Link Rect: 477, 155, 494, 165 ActionDest: 141 Page: Sequence: 8 Annotations: Annotation: Subtype: Link Rect: 328, 710, 345, 719 ActionDest: 141 Annotation: Subtype: Link Rect: 345, 710, 362, 719 ActionDest: 141 Annotation: Subtype: Link Rect: 330, 685, 347, 694 ActionDest: 141 Annotation: Subtype: Link Rect: 348, 685, 365, 694 ActionDest: 141 Annotation: Subtype: Link Rect: 408, 659, 425, 669 ActionDest: 141 Annotation: Subtype: Link Rect: 425, 659, 442, 669 ActionDest: 141 Annotation: Subtype: Link Rect: 239, 634, 256, 643 ActionDest: 141 Annotation: Subtype: Link Rect: 381, 559, 398, 568 ActionDest: 141 Annotation: Subtype: Link Rect: 401, 559, 418, 568 ActionDest: 141 Annotation: Subtype: Link Rect: 487, 484, 504, 493 ActionDest: 141 Annotation: Subtype: Link Rect: 392, 459, 409, 468 ActionDest: 141 Annotation: Subtype: Link Rect: 409, 459, 426, 468 ActionDest: 141 Annotation: Subtype: Link Rect: 207, 433, 224, 443 ActionDest: 141 Annotation: Subtype: Link Rect: 231, 396, 248, 405 ActionDest: 141 Annotation: Subtype: Link Rect: 458, 346, 475, 355 ActionDest: 141 Annotation: Subtype: Link Rect: 519, 296, 536, 304 ActionDest: 141 Annotation: Subtype: Link Rect: 521, 270, 538, 279 ActionDest: 141 Annotation: Subtype: Link Rect: 539, 270, 556, 279 ActionDest: 141 Annotation: Subtype: Link Rect: 178, 167, 318, 179 Annotation: Subtype: Link Rect: 443, 170, 460, 179 ActionDest: 141 Annotation: Subtype: Link Rect: 476, 167, 560, 179 Annotation: Subtype: Link Rect: 166, 154, 284, 166 Annotation: Subtype: Link Rect: 405, 157, 422, 166 ActionDest: 141 Annotation: Subtype: Link Rect: 455, 154, 462, 166 ActionDest: 122 Page: Sequence: 9 Annotations: Annotation: Subtype: Link Rect: 559, 499, 683, 513 Annotation: Subtype: Link Rect: 685, 499, 785, 513 Annotation: Subtype: Link Rect: 56, 485, 136, 498 Page: Sequence: 10 Annotations: Annotation: Subtype: Link Rect: 270, 619, 282, 628 ActionDest: 128 Annotation: Subtype: Link Rect: 282, 619, 299, 628 ActionDest: 141 Annotation: Subtype: Link Rect: 300, 619, 316, 628 ActionDest: 141 Annotation: Subtype: Link Rect: 145, 209, 182, 219 Annotation: Subtype: Link Rect: 344, 185, 381, 196 Annotation: Subtype: Link Rect: 325, 162, 363, 173 Annotation: Subtype: Link Rect: 369, 162, 405, 173 Annotation: Subtype: Link Rect: 386, 139, 423, 150 Annotation: Subtype: Link Rect: 267, 116, 304, 127 Annotation: Subtype: Link Rect: 310, 116, 346, 127 Annotation: Subtype: Link Rect: 59, 70, 97, 81 Page: Sequence: 11 Annotations: Annotation: Subtype: Link Rect: 344, 709, 382, 720 Annotation: Subtype: Link Rect: 388, 709, 424, 720 Annotation: Subtype: Link Rect: 314, 686, 351, 697 Annotation: Subtype: Link Rect: 496, 663, 534, 674 Annotation: Subtype: Link Rect: 163, 640, 200, 651 Annotation: Subtype: Link Rect: 413, 617, 450, 628 Annotation: Subtype: Link Rect: 169, 595, 207, 605 Annotation: Subtype: Link Rect: 213, 595, 249, 605 Annotation: Subtype: Link Rect: 449, 561, 487, 571 Annotation: Subtype: Link Rect: 118, 515, 155, 525 Annotation: Subtype: Link Rect: 162, 515, 198, 525 Annotation: Subtype: Link Rect: 59, 480, 97, 490 Annotation: Subtype: Link Rect: 103, 480, 139, 490 Annotation: Subtype: Link Rect: 59, 423, 97, 433 Annotation: Subtype: Link Rect: 332, 387, 369, 398 Annotation: Subtype: Link Rect: 252, 353, 289, 364 Annotation: Subtype: Link Rect: 319, 318, 357, 329 Annotation: Subtype: Link Rect: 216, 273, 254, 283 Annotation: Subtype: Link Rect: 260, 273, 296, 283 Annotation: Subtype: Link Rect: 226, 238, 264, 249 Annotation: Subtype: Link Rect: 270, 238, 306, 249 Annotation: Subtype: Link Rect: 136, 215, 173, 226 Annotation: Subtype: Link Rect: 179, 215, 215, 226 Annotation: Subtype: Link Rect: 270, 192, 307, 203 Annotation: Subtype: Link Rect: 389, 169, 426, 180 Annotation: Subtype: Link Rect: 433, 169, 469, 180 Annotation: Subtype: Link Rect: 502, 146, 540, 157 Annotation: Subtype: Link Rect: 492, 134, 529, 145 Annotation: Subtype: Link Rect: 375, 100, 412, 111 Annotation: Subtype: Link Rect: 418, 100, 454, 111 Annotation: Subtype: Link Rect: 149, 66, 187, 76 Page: Sequence: 12 Annotations: Annotation: Subtype: Link Rect: 477, 709, 514, 720 Annotation: Subtype: Link Rect: 453, 698, 490, 709 Annotation: Subtype: Link Rect: 200, 664, 238, 674 Annotation: Subtype: Link Rect: 348, 640, 386, 651 Annotation: Subtype: Link Rect: 392, 640, 428, 651 Annotation: Subtype: Link Rect: 517, 617, 554, 628 Annotation: Subtype: Link Rect: 393, 594, 431, 605 Annotation: Subtype: Link Rect: 437, 594, 473, 605 Annotation: Subtype: Link Rect: 477, 571, 515, 582 Annotation: Subtype: Link Rect: 521, 571, 557, 582 Annotation: Subtype: Link Rect: 319, 538, 357, 548 Annotation: Subtype: Link Rect: 363, 538, 399, 548 Annotation: Subtype: Link Rect: 59, 515, 97, 525 Annotation: Subtype: Link Rect: 168, 492, 206, 502 Annotation: Subtype: Link Rect: 504, 479, 541, 490 Annotation: Subtype: Link Rect: 59, 446, 97, 456 Annotation: Subtype: Link Rect: 312, 422, 349, 433 Annotation: Subtype: Link Rect: 486, 399, 523, 410 Annotation: Subtype: Link Rect: 478, 376, 515, 387 Annotation: Subtype: Link Rect: 521, 376, 557, 387 Annotation: Subtype: Link Rect: 371, 353, 409, 364 Annotation: Subtype: Link Rect: 415, 353, 451, 364 Annotation: Subtype: Link Rect: 104, 319, 142, 329 Annotation: Subtype: Link Rect: 366, 295, 404, 306 Annotation: Subtype: Link Rect: 281, 261, 318, 272 Annotation: Subtype: Link Rect: 118, 227, 155, 237 Annotation: Subtype: Link Rect: 518, 169, 556, 180 Annotation: Subtype: Link Rect: 186, 135, 223, 145 Annotation: Subtype: Link Rect: 344, 111, 382, 122 Annotation: Subtype: Link Rect: 388, 111, 424, 122 Annotation: Subtype: Link Rect: 519, 77, 557, 88 Annotation: Subtype: Link Rect: 59, 66, 95, 76 Page: Sequence: 13 Annotations: Annotation: Subtype: Link Rect: 496, 721, 533, 732 Annotation: Subtype: Link Rect: 59, 687, 97, 697 Annotation: Subtype: Link Rect: 103, 687, 139, 697 Annotation: Subtype: Link Rect: 235, 652, 273, 663 Annotation: Subtype: Link Rect: 279, 652, 315, 663 Annotation: Subtype: Link Rect: 407, 640, 445, 651 Annotation: Subtype: Link Rect: 374, 617, 411, 628 Annotation: Subtype: Link Rect: 59, 584, 97, 594 Annotation: Subtype: Link Rect: 397, 560, 434, 571 Annotation: Subtype: Link Rect: 440, 560, 476, 571 Annotation: Subtype: Link Rect: 406, 537, 444, 548 Annotation: Subtype: Link Rect: 384, 514, 421, 525 Annotation: Subtype: Link Rect: 428, 514, 464, 525 Annotation: Subtype: Link Rect: 113, 480, 150, 490 Annotation: Subtype: Link Rect: 475, 456, 513, 467 Annotation: Subtype: Link Rect: 519, 456, 555, 467 Annotation: Subtype: Link Rect: 413, 422, 450, 433 Annotation: Subtype: Link Rect: 456, 422, 492, 433 Annotation: Subtype: Link Rect: 512, 399, 549, 410 Annotation: Subtype: Link Rect: 230, 365, 267, 375 Annotation: Subtype: Link Rect: 59, 331, 97, 341 Annotation: Subtype: Link Rect: 256, 295, 293, 306 Annotation: Subtype: Link Rect: 59, 262, 97, 272 Annotation: Subtype: Link Rect: 196, 238, 234, 249 Annotation: Subtype: Link Rect: 240, 238, 276, 249 Annotation: Subtype: Link Rect: 59, 204, 97, 214 Annotation: Subtype: Link Rect: 397, 180, 434, 191 Annotation: Subtype: Link Rect: 440, 180, 476, 191 Annotation: Subtype: Link Rect: 140, 146, 178, 157 Annotation: Subtype: Link Rect: 184, 146, 220, 157 Annotation: Subtype: Link Rect: 247, 100, 285, 111 Annotation: Subtype: Link Rect: 291, 100, 327, 111 Annotation: Subtype: Link Rect: 325, 65, 362, 76 Annotation: Subtype: Link Rect: 368, 65, 404, 76 Page: Sequence: 14 Annotations: Annotation: Subtype: Link Rect: 275, 709, 312, 720 Annotation: Subtype: Link Rect: 195, 676, 233, 686 Annotation: Subtype: Link Rect: 371, 640, 408, 651 Annotation: Subtype: Link Rect: 353, 606, 391, 617 Annotation: Subtype: Link Rect: 59, 572, 97, 582 Annotation: Subtype: Link Rect: 459, 537, 496, 548 Annotation: Subtype: Link Rect: 167, 492, 205, 502 Annotation: Subtype: Link Rect: 420, 456, 457, 467 Annotation: Subtype: Link Rect: 520, 433, 557, 444 Annotation: Subtype: Link Rect: 59, 423, 95, 433 Annotation: Subtype: Link Rect: 182, 388, 219, 398 Annotation: Subtype: Link Rect: 520, 364, 557, 375 Annotation: Subtype: Link Rect: 59, 354, 95, 364 Annotation: Subtype: Link Rect: 175, 331, 212, 341 Annotation: Subtype: Link Rect: 439, 307, 476, 318 Annotation: Subtype: Link Rect: 482, 307, 518, 318 Annotation: Subtype: Link Rect: 140, 273, 178, 283 Annotation: Subtype: Link Rect: 501, 249, 539, 260 Annotation: Subtype: Link Rect: 167, 227, 205, 237 Annotation: Subtype: Link Rect: 200, 203, 238, 214 Annotation: Subtype: Link Rect: 205, 169, 242, 180 Annotation: Subtype: Link Rect: 430, 123, 467, 134 Annotation: Subtype: Link Rect: 474, 123, 510, 134 Annotation: Subtype: Link Rect: 186, 88, 224, 99 Page: Sequence: 15 Annotations: Annotation: Subtype: Link Rect: 59, 710, 97, 720 Annotation: Subtype: Link Rect: 103, 710, 139, 720 Annotation: Subtype: Link Rect: 437, 675, 474, 686 Annotation: Subtype: Link Rect: 258, 640, 296, 651 Annotation: Subtype: Link Rect: 302, 640, 338, 651 Annotation: Subtype: Link Rect: 252, 606, 290, 617 Annotation: Subtype: Link Rect: 131, 584, 169, 594 Annotation: Subtype: Link Rect: 131, 538, 169, 548 Annotation: Subtype: Link Rect: 246, 514, 284, 525 Annotation: Subtype: Link Rect: 140, 480, 178, 490 Annotation: Subtype: Link Rect: 184, 480, 220, 490 Annotation: Subtype: Link Rect: 198, 445, 235, 456 Annotation: Subtype: Link Rect: 242, 445, 278, 456 Annotation: Subtype: Link Rect: 110, 411, 147, 421 Annotation: Subtype: Link Rect: 153, 411, 189, 421 Annotation: Subtype: Link Rect: 258, 387, 295, 398 Annotation: Subtype: Link Rect: 373, 364, 410, 375 Annotation: Subtype: Link Rect: 317, 341, 354, 352 Annotation: Subtype: Link Rect: 343, 318, 380, 329 Annotation: Subtype: Link Rect: 176, 295, 213, 306 Annotation: Subtype: Link Rect: 220, 295, 256, 306 Annotation: Subtype: Link Rect: 109, 262, 146, 272 Annotation: Subtype: Link Rect: 152, 262, 188, 272 Annotation: Subtype: Link Rect: 109, 238, 146, 249 Annotation: Subtype: Link Rect: 261, 203, 298, 214 Annotation: Subtype: Link Rect: 304, 203, 341, 214 Annotation: Subtype: Link Rect: 308, 180, 345, 191 Annotation: Subtype: Link Rect: 352, 180, 388, 191 Annotation: Subtype: Link Rect: 321, 157, 359, 168 Annotation: Subtype: Link Rect: 289, 134, 327, 145 Annotation: Subtype: Link Rect: 238, 123, 400, 134 Annotation: Subtype: Link Rect: 231, 111, 420, 122 Annotation: Subtype: Link Rect: 131, 89, 169, 99 Annotation: Subtype: Link Rect: 158, 66, 196, 76 Checksum: 18ee676b Type: CRC32 Checksum: 5c3d32d4eb4f6c6b597cbef0932171fb Type: MD5 Checksum: fd0ae58366da56150f3ed9b50dc228b48577d5da Type: SHA-1