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AIDS-related lymphomas: Epidemiology, risk factors, and pathobiology

Lawrence D Kaplan, MD
Wei Ai, MD, PhD
Section Editor
Arnold S Freedman, MD
Deputy Editor
Alan G Rosmarin, MD


Human immunodeficiency virus (HIV) infection results in impaired cellular immunity, a condition known to predispose persons to develop neoplasms [1-4]. As the lifespan of HIV-infected patients has increased, malignancies have become a known cause of morbidity and mortality in this population. Before the advent of antiretroviral therapy (ART), malignancies accounted for approximately 10 percent of HIV-related deaths. Since the routine implementation of ART therapy, a cancer diagnosis is made in over 40 percent of HIV-infected patients during the course of the HIV infection [5], and over 28 percent of HIV-related deaths are attributable to malignancy [6,7].

There are three acquired immune deficiency syndrome (AIDS)-defining malignancies: Kaposi's sarcoma, non-Hodgkin lymphoma (NHL) of high-grade pathologic type and of B cell or unknown immunologic phenotype [8], and invasive cervical carcinoma. In addition, non-AIDS-defining malignancies contribute to mortality in HIV-infected persons. (See "HIV infection and malignancy: Epidemiology and pathogenesis" and "HIV infection and malignancy: Management considerations".)

The epidemiology, risk factors, and pathobiology of AIDS-related NHL will be reviewed here. Issues related to the treatment of NHL in this population are discussed separately. (See "AIDS-related lymphomas: Treatment of systemic lymphoma" and "AIDS-related lymphomas: Primary central nervous system lymphoma", section on 'Treatment' and "AIDS-related lymphomas: Primary effusion lymphoma", section on 'Treatment'.)


General issues — Among those with HIV, 25 to 40 percent will develop a malignancy, with approximately 10 percent developing non-Hodgkin lymphoma (NHL) [1,3,5,7,9-17]. Compared with non-HIV-infected patients, patients who are seropositive for HIV have a substantially increased risk of developing lymphoma. As examples:

A series of 1073 HIV positive patients reported a total cancer incidence of 4 percent per year; the rate of NHL was 1.2 percent per year [12].


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Literature review current through: Sep 2016. | This topic last updated: Oct 21, 2016.
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