HIV positivity may not have a negative impact on survival in Epstein-Barr virus-positive Hodgkin lymphoma: A Japanese nationwide retrospective survey.

There has been no comparative clinical study focused on differences in the clinical features of Epstein-Barr virus (EBV) Hodgkin lymphoma (HL) between HIV-positive and -negative cases. In a nationwide survey from 511 institutions in Japan, the present study investigated 16 EBV+ HIV HL patients. To further clarify their characteristics in comparison with EBV+ HIV HL (n=34) in the combination antiretroviral therapy era in Japan, the present study was performed. Results indicated that EBV HIV HL frequently occurred in a younger population compared with EBV HIV HL (P=0.0295), and that the EBV HIV HL group was not associated with the nodular sclerosis subtype in the population who were below the age of 40. Notably, the EBV HIV HL group had a significantly higher frequency of extra-nodal involvement (P=0.0214), including marrow invasion. In the advanced stage, 80% of those with EBV HIV HL did not require dose-reduction and in the majority of cases, chemotherapy was completed. There were no significant differences in the complete remission rate (P=0.1961), overall survival (P=0.200) and progression-free survival (P=0.245) between EBV HIV HL (median observational period, 23.5 months) and EBV HIV HL (median observational period, 64.5 months), suggesting that HIV positivity may not have a negative impact on the clinical outcome of EBV HL. Notably, standard chemotherapy is effective and tolerable for EBV HL, regardless of HIV infection.