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Lymphomas associated with HIV infection

J Diebold1, M Raphael, S Prévot

  • 1Department of Pathology, Hôtel Dieu, Paris, France.

Cancer Surveys
|January 1, 1997
PubMed
Summary
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Lymphomagenesis in HIV patients involves complex interactions. Epstein-Barr virus (EBV) plays a role in various lymphomas, with different EBV statuses observed in Burkitt and diffuse large cell lymphomas.

Area of Science:

  • Oncology
  • Virology
  • Immunology

Background:

  • Lymphomagenesis in Human Immunodeficiency Virus (HIV)-positive patients is complex and not fully understood.
  • Non-Hodgkin lymphomas (NHL) in HIV patients are predominantly B-cell type.
  • Epstein-Barr virus (EBV) is implicated in the development of these lymphomas.

Purpose of the Study:

  • To elucidate the complex mechanisms of lymphomagenesis in HIV-positive individuals.
  • To differentiate the characteristics of various lymphoma subtypes in the context of HIV infection.
  • To investigate the role of Epstein-Barr virus (EBV) in HIV-associated lymphomas.

Main Methods:

  • Analysis of lymphoma subtypes based on CD4 counts and disease progression in HIV patients.
  • Assessment of MYC gene rearrangement in lymphoma cases.

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  • Evaluation of Epstein-Barr virus (EBV) status, including EBNA2 and LMP1 expression, and association with specific lymphoma types.

    • Main Results:

    • Burkitt lymphoma occurs early in HIV infection (CD4 > 200/µL), often with MYC rearrangement and EBV negativity (EBNA2/LMP1-).
    • Diffuse large cell lymphomas occur late in HIV infection (CD4 < 50/µL), with worse prognosis, MYC rearrangement in 30-40%, and EBV positivity (EBNA2/LMP1+).
    • HIV-associated Hodgkin disease (HD) shows aggressive behavior, with neoplastic cells consistently EBV positive.

    Conclusions:

    • Lymphomagenesis in HIV is multifactorial, involving immune deficiency, EBV, other viruses, gene rearrangements, and cytokines.
    • Distinct EBV profiles characterize different HIV-associated lymphoma subtypes.
    • HIV-associated lymphomas, including HD, exhibit unique epidemiological and etiological features compared to non-HIV counterparts.