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  • Review Article
  • Published:

Diagnosis and management of lymphomas and other cancers in HIV-infected patients

Nature Reviews Clinical Oncology volume 11, pages 223–238 (2014)Cite this article

Subjects

Key Points

  • Lymphomas represent the most frequent malignancy among HIV-infected people

  • The most common lymphomas that arise in HIV-associated patients are Burkitt lymphoma, diffuse large B-cell lymphomas, and Hodgkin lymphoma—the latter is the most common non AIDS-defining cancer type

  • Some rare types of lymphomas, such as primary effusion lymphomas, occur nearly exclusively in people with HIV and/or AIDS

  • Non AIDS-defining cancers are mostly infection-related, and exhibit histopathological and immunophenotypical features similar to those observed in HIV-negative patients

  • The combination of cART and antineoplastic treatment has provided remarkable results in the most common lymphomas that arise in HIV-infected patients

  • In people with HIV and/or AIDS, improved screening strategies are required to actively detect oncogenic viruses, precancerous lesions, and early stage malignant disease

Abstract

Despite the introduction of highly active antiretroviral therapy or combination antiretroviral therapy (HAART and cART, respectively) patients infected with HIV might develop certain types of cancer more frequently than uninfected people. Lymphomas represent the most frequent malignancy among patients with HIV. Other cancer types that have increased in these patients include Kaposi sarcoma, cancer of the cervix, anus, lung and liver. In the post-HAART era, however, patients with HIV have experienced a significant improvement in their morbidity, mortality and life expectancy. This Review focuses on the different types of lymphomas that generally occur in patients with HIV. The combination of cART and antineoplastic treatment has resulted in remarkable prolongation of disease-free survival and overall survival among patients with HIV who develop lymphoma. However, the survival in these patients still lags behind that of patients with lymphoma who are not infected with HIV. We also provide an update of epidemiological data, diagnostic issues, and strategies regarding the most-appropriate management of patients with both HIV and lymphomas.

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Figure 1: HIV-associated Burkitt lymphoma.
Figure 2: HIV-associated DLBCL.
Figure 3: AIDS and non AIDS-defining cancers.

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Acknowledgements

A.C. and S.F. are Members of WHO IARC Monograph Working Group on Biological Agents, Lyon, 2009. This work was supported in part by an Institutional grant from Centro di Riferimento Oncologico Aviano for an intramural project “Infectious agents and cancer” (A.C.), by an Institutional grant from the Fondazione IRCSS Istituto Nazionale Tumori Milano “Validation of a new algorithm for HPV status assessment in head and neck carcinoma” (A.G.).

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Authors and Affiliations

  1. Department of Pathology, Centro di Riferimento Oncologico Aviano (CRO), Istituto Nazionale Tumori, Italy

    Antonino Carbone

  2. Department of Medical Oncology, Centro di Riferimento Oncologico Aviano (CRO), Istituto Nazionale Tumori, Italy

    Emanuela Vaccher

  3. Molecular Virology and Scientific Directorate, Centro di Riferimento Oncologico Aviano (CRO), Istituto Nazionale Tumori, Italy

    Paolo de Paoli

  4. Department of Diagnostic Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori Milano, Italy

    Annunziata Gloghini

  5. Department of Pathology, University of Pittsburgh Medical Center, USA

    Liron Pantanowitz

  6. Department of Pathology, Division of Haematology, Tygerberg Hospital, South Africa

    Akin Abayomi

  7. Infections and Cancer Epidemiology Group, International Agency for Research on Cancer, France

    Silvia Franceschi

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A.C. and S.F. researched data for the article. A.C., E.V., A.G., L.P., A.A., P.d.P. and S.F. all equally contributed to discussion of the content and to the writing of the manuscript.

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Carbone, A., Vaccher, E., Gloghini, A. et al. Diagnosis and management of lymphomas and other cancers in HIV-infected patients. Nat Rev Clin Oncol 11, 223–238 (2014). https://doi.org/10.1038/nrclinonc.2014.31

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