Lymphomas associated with HIV infection

Abstract

INCE the initial reports of non-Hodgkin’s lymphoma (NHL) in patients with acquired immunodeficiency syndrome (AIDS) in 1982,‘,* it has become increasingly apparent that individuals with human immunodeficiency virus (HIV) infection are at an increased risk of developing aggressive malignant lymphomas.3-5 indeed, a diagnosis of high-grade B-cell lymphoma or primary cranial lymphoma in an HIV-infected patient is now recognized as an indicator disease of AIDS.6 These lymphomas mostly affect young males and are predominantly high- and intermediate-grade histologic type, according to the working formulation.7 Patients often present with advanced disease in extranodal sites, particularly the central nervous system (CNS), bone marrow, and gastrointestinal (GI) tract. 3-5 Response to chemotherapy is poor and the prognosis is dismal, with a median survival of less than 1 year.4 Although Hodgkin’s disease has also been described in association with HIV infection,*-‘* it is currently not included among the diagnostic criteria of AIDS. We review herein the incidence, clinical features, pathology, treatment, prognosis, and pathogenesis of lymphomas associated with HIV infection. [Nursing management of many of the problems associated with lymphomas is discussed by McMahon and Coyne elsewhere in this issue.]