question: Q:Please refer to the summary above to answer this question
  A 63-year-old HIV-positive man comes to the physician for a routine health maintenance examination. Four years ago, he was diagnosed with HIV and was started on cART therapy. He tells the physician that he has been having difficulty adhering to his medication regimen. He has been unemployed for the past couple of years and relies on unemployment benefits to cover the costs of daily living. His father died of lymphoma at the age of 60 years. He had recently heard about the results of the study featured in the abstract and wants more information about his risk of developing DLBCL. Based on the study, which of the following is the greatest risk factor for the development of DLBCL in HIV-positive patients?"? 
  {'A': 'Positive family history of cancer', 'B': 'Male sex', 'C': 'Poor adherence to cART', 'D': 'Income below $30,000 per year', 'E': 'Age over 55 years\n"'},