[AIDS-related non-Hodgkin lymphomas. Clinical picture and prognosis]

Patients infected with HIV are at high risk for developing non-Hodgkin's lymphomas (NHL). HIV-associated NHLs seem to be increasing in number. They consist of two major histopathological subtypes originating from B-lymphocytes: Burkitt-like lymphomas and diffuse large cell lymphomas. There seems to be a clear association between Epstein-Barr virus (EBV) and immunoblastic lymphomas (a subtype of large cell lymphomas) in AIDS patients. Patients with AIDS often have widespread disease at presentation and frequent involvement of extranodal sites (CNS, liver, bone marrow, the digestive tract and skin). The treatment of NHL in AIDS patients is controversial due to their poor response to chemotherapy as well as a tendency to develop severe hematological toxicity. Factors with a negative influence on the prognosis are: Extranodal localisation of NHL including CNS, CD4 count below 200 x 10(6)/l, platelet count below 130 x 10(9)/l, widespread symptoms of disease, presence of EBV in the lymphoma and immunoblastic histology.