AIDS-associated non-Hodgkin's lymphoma in the era of highly active antiretroviral therapy

J Acquir Immune Defic Syndr. 1999 Aug 1:21 Suppl 1:S27-30.

Abstract

In populations receiving highly active antiretroviral therapy (HAART), the incidence of non-Hodgkin's lymphoma (NHL) has decreased by less than other AIDS-associated illnesses. In Australian AIDS-registration data, NHL has decreased by 37.5% since 1994, compared with a 55% decrease for other AIDS-associated illnesses (p = .033). Three factors may contribute to this discrepancy. First, in contrast to most other AIDS-associated illness, molecular and epidemiologic evidence suggests that there is no single organism that causes AIDS-related NHL. Thus, the HAART-induced partial recovery of reactivity to foreign antigens may be relatively ineffective in NHL prevention. Second, with the exception of primary NHL of the central nervous system, AIDS-related NHL tends to occur at a less advanced stage of immune deficiency than other AIDS-related diseases; therefore, the HAART-associated partial recovery of the immune system may be insufficient to prevent NHL. Third, it is unclear whether HAART is fully effective at reversing the B-cell stimulation that is associated with HIV infection and is a risk factor for NHL. Unless more complete immune reconstitution can be achieved, it is likely that NHL will become proportionately more important as a cause of morbidity and mortality in people with HIV and AIDS.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • AIDS-Related Opportunistic Infections / drug therapy
  • AIDS-Related Opportunistic Infections / epidemiology*
  • AIDS-Related Opportunistic Infections / immunology
  • Anti-HIV Agents* / administration & dosage
  • B-Lymphocytes / drug effects
  • B-Lymphocytes / immunology
  • Humans
  • Incidence
  • Lymphoma, AIDS-Related / epidemiology*
  • Lymphoma, Non-Hodgkin / epidemiology*

Substances

  • Anti-HIV Agents