HIV and indolent lymphoma

Abstract

The incidence of non-Hodgkin’s lymphoma (NHL) is at least 100 times higher in the human immunodeficiency virus (HIV)-infected population as compared with the general population. Approximately 3 % of HIV/AIDS patients develop NHL. Among them, the risk increases with older age, duration of infection, and with a history of AIDS-defining events. Data supporting a decline in NHL in the post-HAART era are inconsistent. A prolonged immunocompromised state, with reduced immune surveillance, and chronic antigen stimulation, in the setting of infection with HIV, are contributors to the pathogenesis of NHL. Studies suggest that there are increased p53 gene abnormalities in HIV-1-related NHL. In this chapter, we will focus on the indolent subset of NHL in the HIV-infected population. Of the AIDS-defining illnesses, there are two subtypes of aggressive NHL including Burkitt lymphoma and DLBCL, which are disproportionately more prevalent among HIV lymphoma subtypes. There is a contradistinction in the prevalence of indolent subtypes of NHL in the HIV population, with the incidence rates of these lymphomas being lower as compared with the indolent subtypes in the general population, as described in SEER database analysis of patients from 1992 to 2009, suggesting less of an association with HIV.