Ruiz Marco, Parsons Christopher, Cole John
1Section of Infectious Diseases and Geriatric Medicine, Department of Medicine, Louisiana State University Health Sciences Center in New Orleans, New Orleans, LA, USA.
J Int Assoc Physicians AIDS Care (Chic). 2012 Jul-Aug;11(4):234-8. doi: 10.1177/1545109711431492. Epub 2012 Feb 1.
Although the incidence and prevalence of AIDS-defining malignancies has decreased in the era of highly active antiretroviral therapy (HAART), the incidence and prevalence of Hodgkin's lymphoma (HL) in the HIV-infected population continues to rise. Compared with the general population, HIV-infected patients exhibit a 5-10-fold increased risk for developing HL.
A retrospective review of charts and electronic records from 2000-2010 at the HIV outpatient clinic (HOP)-Louisiana State University in New Orleans was conducted, and pathologically confirmed cases of HIV-HL were identified within this cohort.
We found a prevalence of 6.3 cases per 1,000 patients per year of HIV-HL over a period of 10 years in our HIV outpatient clinic. The mean absolute CD4 count before treatment was 284 cells/mm(3) and after treatment was 194 cells/mm(3). The average time from the diagnosis of HIV infection to the diagnosis of HIV-HL was 7.6 years. The most common histopathologic type was mixed cellularity followed by lymphocytic predominance. The majority of patients had 6 cycles delivered. In terms of HL staging 87% presented with advanced stages (III B or IV). To the best of our knowledge 5 out of the 14 patients remain alive.
Patients in our cohort were older than most patients identified in other cohorts. All of our patients had coexisting chronic illnesses associated with inflammation, as well as detectable HIV viral loads and CD4 count >200, suggesting a role for both HIV- and non-HIV-associated inflammation in HIV-HL pathogenesis in this population. The role of HIV virus and other oncogenic viruses (EBV, HPV, and others) in the pathogenesis of Hodgkin's lymphoma in this group of patients needs to be elucidated.
尽管在高效抗逆转录病毒治疗（HAART）时代，艾滋病定义性恶性肿瘤的发病率和患病率有所下降，但HIV感染人群中霍奇金淋巴瘤（HL）的发病率和患病率仍在持续上升。与普通人群相比，HIV感染患者患HL的风险增加了5至10倍。
对新奥尔良路易斯安那州立大学HIV门诊（HOP）2000年至2010年的病历和电子记录进行回顾性研究，在该队列中确定经病理证实的HIV-HL病例。
我们发现，在我们的HIV门诊中，10年间HIV-HL的患病率为每年每1000名患者中有6.3例。治疗前平均绝对CD4细胞计数为284个/立方毫米，治疗后为194个/立方毫米。从HIV感染诊断到HIV-HL诊断的平均时间为7.6年。最常见的组织病理学类型是混合细胞型，其次是淋巴细胞为主型。大多数患者接受了6个周期的治疗。在HL分期方面，87%的患者表现为晚期（III B或IV期）。据我们所知，14名患者中有5名仍然存活。
我们队列中的患者比其他队列中发现的大多数患者年龄更大。我们所有的患者都患有与炎症相关的共存慢性病，以及可检测到的HIV病毒载量和CD4细胞计数>200，这表明HIV相关和非HIV相关炎症在该人群的HIV-HL发病机制中都起作用。HIV病毒和其他致癌病毒（EBV、HPV等）在这组患者霍奇金淋巴瘤发病机制中的作用需要阐明。
