HIV-related Lymphoma

Belinda Lee; Mark Bower; Thomas Newsom-Davis; Mark Nelson

Disclosures

HIV Ther. 2010;4(6):649-659. 

In This Article

Abstract and Introduction

Abstract

Since the introduction of highly active antiretroviral therapy, the natural history of HIV infection has changed dramatically, and with it the epidemiology of HIV-related lymphoma. HIV-related lymphomas have increased as a percentage of first AIDS-defining illness. The most prevalent of the HIV-related lymphomas is diffuse large B-cell non-Hodgkin's lymphoma, followed by Burkitt's lymphoma. Although not considered an AIDS-defining illness, Hodgkin's lymphoma is increasing in incidence in those with HIV infection. Treatment outcome and prognosis has improved significantly over the last decade. Paradigms of therapy have shifted, with approaches aimed at complete remission rather than palliation. This review discusses the biology and changes in epidemiology of HIV-related lymphoma and also reviews other key developments in the management of this disease.

Introduction

Since the emergence of AIDS in 1981, an association between HIV infection and the development of specific cancers has been recognized. This group of cancers includes the three AIDS-defining malignancies: high-grade B-cell non-Hodgkin's lymphoma (NHL), Kaposi's sarcoma (KS) and invasive cervical cancer. Immune suppression rather than HIV itself is implicated in the pathogenesis of these malignancies, with a clear correlation between the degree of immune suppression and the risk of developing NHL and KS.[1–4] In addition, an increased incidence of other non-AIDS-defining cancers, including Hodgkin's lymphoma (HL), has been noted.[5]

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