Abstract
BackgroundB cell non Hodgkin lymphomas account for the majority of lymphomas in Uganda. The commonest is endemic Burkitt lymphoma, followed by diffuse large-B-cell lymphoma (DLBCL). There has been an increase in incidence of malignant lymphoma since the onset of the HIV/AIDS pandemic. However, the possible linkages of HHV8 and EBV to the condition of impaired immunity present in AIDS are still not yet very clearly understood.Objectives1. To describe the prevalence of Epstein-Barr virus, Human Herpes virus 8 and Human Immunodeficiency Virus-1 in B cell non Hodgkin lymphoma biopsy specimens in Kampala, Uganda.2. To describe the histopathology of non Hodgkin lymphoma by HIV serology test result in Kampala, UgandaMethodTumour biopsies specimens from 119 patients with B cell non Hodgkin lymphoma were classified according to the WHO classification. Immunohistochemistry was used for detection of HHV8 and in situ hybridization with Epstein Barr virus encoded RNA (EBER) for EBV. Real time and nested PCR were used for the detection of HIV.The patients from whom the 1991-2000 NHL biopsies had been taken did not have HIV serology results therefore 145 patients biopsies where serology results were available were used to describe the association of HIV with non Hodgkin lymphoma type during 2008-2009.ResultsIn this study, the majority (92%) of the Burkitt lymphomas and only 34.8% of the diffuse large B cell lymphomas were EBV positive. None of the precursor B lymphoblastic lymphomas or the mantle cell lymphomas showed EBV integration in the lymphoma cells.None of the Burkitt lymphoma biopsies had HIV by PCR. Of the 121 non Hodgkin B cell lymphoma patients with HIV test results, 19% had HIV. However, only 1(0.04%) case of Burkitt lymphoma had HIV. All the tumours were HHV8 negative.ConclusionsThe majority of the Burkitt lymphomas and two fifths of the diffuse large B cell lymphomas had EBV. All the tumours were HHV8 negative. Generally, the relationship of NHL and HIV was weaker than what has been reported from the developed countries. We discuss the role of these viruses in lymphomagenesis in light of current knowledge.
Highlights
The frequency of non Hodgkin lymphomas (NHLs) has increased since the beginning of the Human immunodeficiency virus (HIV)/AIDS pandemic in the early 1980s[1]
The relationship of NHL and HIV was weaker than what has been reported from the developed countries
Studies have shown an association of non Hodgkin lymphomas (NHLs) with two gamma herpes viruses, Epstein-Barr virus (EBV) and Kaposi sarcoma herpes virus (KSHV)/ Human herpes virus-8(HHV 8)[2,3]
Summary
The frequency of non Hodgkin lymphomas (NHLs) has increased since the beginning of the HIV/AIDS pandemic in the early 1980s[1]. EBV is important in the causation of Burkitt lymphoma (BL), Hodgkin lymphoma and other non Hodgkin lymphomas whereas HHV8 serves as an important co-factor in the pathogenesis of primary effusion lymphoma (PEL) and large B cell lymphomas arising in patients with multicentric Castleman's disease who are profoundly immunosuppressed[4,5]. HIV associated lymphomas are high grade and of B cell origin They are mainly extranodal and have poor prognosis. The systemic lymphomas include Burkitt lymphoma, diffuse large B cell lymphoma with immunoblastic (IB) morphology, HHV8+ primary effusion lymphoma (PEL) and its solid variant and plasmablastic lymphoma (PBL)[6]. The possible linkages of HHV8 and EBV to the condition of impaired immunity present in AIDS are still not yet very clearly understood
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