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人类免疫缺陷病毒相关霍奇金淋巴瘤

HIV-associated Hodgkin lymphoma.

作者信息

Carbone Antonino, Gloghini Annunziata, Serraino Diego, Spina Michele

机构信息

Department of Pathology, Fondazione IRCCS, Istituto Nazionale Tumori, Milan, Italy.

出版信息

Curr Opin HIV AIDS. 2009 Jan;4(1):3-10. doi: 10.1097/COH.0b013e32831a722b.

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.

摘要

综述目的

本综述聚焦于目前关于人类免疫缺陷病毒相关霍奇金淋巴瘤(HIV-HL)的流行病学、病理学及治疗的知识。

最新发现

在非艾滋病定义性癌症中,近期观察到霍奇金淋巴瘤风险增加。然而,HIV感染、艾滋病与霍奇金淋巴瘤之间的关系仍不明确。

总结

在高效抗逆转录病毒治疗时代,HIV感染者患霍奇金淋巴瘤的风险似乎比疫情最初几年有所增加。在这些免疫力有所改善的人群中,CD4+T细胞增加为肿瘤细胞提供了抗凋亡途径及免疫逃逸机制,就如同在无艾滋病的人群中的经典霍奇金淋巴瘤那样。多项研究表明,与未感染HIV人群中的霍奇金淋巴瘤相比,HIV感染者中霍奇金淋巴瘤亚型的分布存在显著差异。HIV-HL分别表现出与细胞背景及肿瘤细胞群体丰度相关的特殊特征。几乎所有HIV-HL病例中都表达潜伏膜蛋白1这一事实表明,爱泼斯坦-巴尔病毒在HIV-HL发病机制中起病因学作用。本文还讨论了联合治疗的最新进展,这些进展已开始在治疗这种HIV相关疾病中显示出前景。

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