Navarro Jose-Tomas, Moltó José, Tapia Gustavo, Ribera Josep-Maria
Department of Hematology, Institute Català d'Oncologia-Germans Trias i Pujol Hospital, Carretera de Canyet s/n, 08916 Barcelona, Spain.
Josep Carreras Leukaemia Research Institute, 08916 Badalona, Spain.
Cancers (Basel). 2021 Aug 29;13(17):4366. doi: 10.3390/cancers13174366.
Despite widespread use of combined antiretroviral therapy (cART) and increased life expectancy in people living with HIV (PLWH), HIV-related lymphomas (HRL) remain a leading cause of cancer morbidity and mortality for PLWH, even in patients optimally treated with cART. While the incidence of aggressive forms of non-Hodgkin lymphoma decreased after the advent of cART, incidence of Hodgkin lymphoma (HL) has increased among PLWH in recent decades. The coinfection of Epstein-Barr virus plays a crucial role in the pathogenesis of HL in the HIV setting. Currently, PLWH with HRL, including HL, are treated similarly to HIV-negative patients and, importantly, the prognosis of HL in PLWH is approaching that of the general population. In this regard, effective cART during chemotherapy is strongly recommended since it has been shown to improve survival rates in all lymphoma subtypes, including HL. As a consequence, interdisciplinary collaboration between HIV specialists and hemato-oncologists for the management of potential drug-drug interactions and overlapping toxicities between antiretroviral and antineoplastic drugs is crucial for the optimal treatment of PLWH with HL. In this article the authors review and update the epidemiological, clinical and biological aspects of HL presenting in PLWH with special emphasis on advances in prognosis and the factors that have contributed to it.
尽管联合抗逆转录病毒疗法（cART）已广泛应用，且感染人类免疫缺陷病毒（HIV）者（PLWH）的预期寿命有所延长，但HIV相关淋巴瘤（HRL）仍是PLWH癌症发病和死亡的主要原因，即使在接受cART最佳治疗的患者中也是如此。虽然cART出现后侵袭性非霍奇金淋巴瘤的发病率有所下降，但近几十年来，霍奇金淋巴瘤（HL）在PLWH中的发病率却有所上升。在HIV感染背景下，爱泼斯坦-巴尔病毒的合并感染在HL的发病机制中起着关键作用。目前，患有HRL（包括HL）的PLWH的治疗方法与HIV阴性患者相似，重要的是，PLWH中HL的预后正在接近普通人群。在这方面，强烈建议在化疗期间进行有效的cART，因为已证明它能提高所有淋巴瘤亚型（包括HL）的生存率。因此，HIV专家和血液肿瘤学家之间就抗逆转录病毒药物和抗肿瘤药物之间潜在的药物相互作用和重叠毒性进行跨学科合作，对于PLWH合并HL的最佳治疗至关重要。在本文中，作者回顾并更新了PLWH中HL的流行病学、临床和生物学方面的内容，特别强调了预后方面的进展及其促成因素。
