Human immunodeficiency virus (HIV) infection in patients with lymphoid neoplasia

Fourty-four patients with lymphoid neoplasia 37 males and 7 females aged 15 to 75 years, were seen in the Department of Internal Medicine, Tikur Anbessa (Black Lion) Hospital, Addis Ababa, Ethiopia, between January and December 1988. Twenty-seven (61.4%) had non-Hodgkin's lymphoma, eleven (25%) Hodgkin's disease and six (13.6%) chronic lymphocytic leukaemia. Six (22.2%) of the non-Hodgkin's lymphoma one, (9.1%) of the Hodgkin's disease and none of the chronic lymphocytic leukaemia cases had positive enzyme linked immunosorbent assay (ELISA) and Western Blot tests for human immunodeficiency virus (HIV) infection. Of the 6 non-Hodgkin's lymphoma patients with HIV infection, five had extra-nodal involvement--four of the gastrointestinal tract, including the oropharynx, and one of the cervix uteri. Four of these six had clinically advanced disease at the time of presentation and histologically three patients had intermediate and three high grade malignancy. Two of the patients have died within two months of diagnosis, one is lost to follow up, and three patients are still alive and well 12 to 46 months after diagnosis. The HIV positive patient with Hodgkin's disease had stage IV E disease involving the pancreas with mixed cellularity histology, and died seven months after diagnosis. Diffuse, aggressive non-Hodgkin's lymphoma and possibly atypical aggressive Hodgkin's disease, may be indicator diseases for AIDS in HIV seropositive individuals.