HIV-associated Hodgkin lymphoma

Abstract

Purpose of review: The focus of this review is on the current knowledge on epidemiology, pathology and treatment of HIV-associated Hodgkin lymphoma (HIV-HL).

Recent findings: Among non-AIDS-defining cancers, an increased risk of Hodgkin lymphoma was recently observed. However, the relationship between HIV infection, AIDS and Hodgkin lymphoma is still unclear.

Summary: In the highly active antiretroviral therapy era, HIV-infected people seem to be at increased risk of Hodgkin lymphoma than in first years of the epidemic. In these persons with improved immunity, increased CD4+ T cells provide antiapoptotic pathways and mechanisms for immune escape by tumor cells, as occurs in classic Hodgkin lymphoma among people without AIDS. Several studies have documented a significant difference in the distribution of Hodgkin lymphoma subtypes in HIV-infected persons as compared with Hodgkin lymphoma in HIV-uninfected population. HIV-HL exhibits special features related to the cellular background and the abundance of the neoplastic cell population, respectively. The fact that latent membrane protein 1 is expressed in virtually all HIV-HL cases suggests that Epstein-Barr virus plays an etiological role in the pathogenesis of HIV-HL. Recent advances in combined therapies, which are beginning to show promise in the treatment of this HIV-associated disorder, are discussed.