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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Incidence of HD varies from about 0.5 per 100,000 person-years in parts of Asia to over 3 in parts of North America. In recent decades, many registries have reported slightly declining age adjusted incidence among men and women. Some lymphomas previously diagnosed as HD now would be classified as NHL, but this shift does not explain all of the decline. When analysed by age group, incidence has decreased substantially at older ages, whereas increases have been reported among young adults in some industrial countries. Less developed countries continue to show high rates in childhood. Hodgkin's disease of the nodular sclerosis subtype has increased over time, whereas HD of mixed cellularity has declined. Improved therapy for HD has led to sharply declining mortality rates, but further understanding of the role of EBV and other possible causal agents should afford opportunities for prevention. Non-Hodgkin's lymphoma stands out from most other malignancies because incidence and mortality rates have risen dramatically, steadily and almost universally during the past few decades. Incidence overall has been rising 3-4% per year. No sudden rise has occurred in specific birth cohorts or calendar year of diagnosis, although incidence rates have increased more steeply at older ages. Diagnosis of NHL has improved with time, perhaps beyond the ways considered herein, but has it improved so much more than diagnosis of other malignancies, and roughly simultaneously around the world? Although it appears that diagnostic improvements are partly responsible for the upward trend, it is likely that aetiological factors are playing an important part. Infections with HIV have started to inflate NHL incidence rates further but cannot account for the striking trend already under way for several decades. Clues should be vigorously pursued to determine the role of other known viruses, immunosuppressive states, herbicides and other chemicals in the environment, and commercial products such as hair dyes. To clarify reasons for the upward trends and to take preventive action will require a better understanding of the origins of the lymphomas through epidemiological research, including interdisciplinary approaches that can identify new viruses, host-environmental interactions and lifestyle and other exposures that alter susceptibility.
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PMID:Hodgkin's and non-Hodgkin's lymphomas. 753 35

Human immunodeficiency virus (HIV) related cancers in children are not as common and as well described as in adults. An HIV epidemic has been prevalent in Zambia since 1983-1984. To study the effect of the epidemic on the epidemiology of cancers in children a retrospective study was undertaken at the University Teaching Hospital (UTH), Lusaka, Zambia. All the histopathological records from 1980 to 1992 were reviewed and all cases of cancers in children less than 14 years of age were analysed. In order to define the effect of the HIV epidemic, the epidemiological features of various childhood cancers occurring before (during the years 1980-1982) and after (during the years 1990-1992) the onset of the HIV epidemic were compared. A significant increase in the occurrence of total childhood cancers was found. This is mostly due to a highly significant increase in the incidence of paediatric Kaposi's sarcoma (p = 0.000016), which is causally related to HIV infection, and a significant increase in the incidence of retinoblastoma (p = 0.02), which has an unknown relation to HIV infection. Though not yet statistically significant, there has also been a gradual and sustained increase in the incidence of non-Hodgkin's lymphoma, nasopharyngeal carcinoma, and rhabdomyosarcoma. There has been a significant reduction in the incidence of Burkitt's lymphoma. A prospective in depth epidemiological study of HIV related childhood cancers in Africa is urgently needed.
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PMID:Childhood cancers in Zambia before and after the HIV epidemic. 757 50

AIDS is associated with a high risk of certain malignancies, notably Kaposi's sarcoma (KS) and B-cell non-Hodgkin's lymphoma (NHL). The pathogenesis of these malignancies is not fully understood. One mechanism of malignant transformation recently described in colon tumorigenesis results from defects in DNA mismatch repair, manifest as widespread microsatellite instability. We demonstrate a high rate of microsatellite instability in KS and aggressive lymphomas obtained from HIV-infected patients, whereas there is no evidence of instability in similar lesions from HIV-negative patients. Further elucidation of the underlying mechanisms responsible for HIV-associated instability in primary tumours may provide insight into the pathogenesis of these AIDS-related neoplasms.
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PMID:Microsatellite instability in primary neoplasms from HIV + patients. 758 55

The epidemiology of HIV associated non-Hodgkin's lymphoma (NHL) was investigated in 6550 European patients with AIDS. NHL was diagnosed in 3.5% of all patients at the time of the AIDS diagnosis. Although the probability of being diagnosed with NHL at AIDS diagnosis was significantly higher among intravenous drug users than among homosexual men, and was associated with increasing age, the observed incidences of NHL were more strikingly similar than any differences. The rate of developing NHL after a previous AIDS diagnosis was 2.4 per 100 patient years of follow-up, and remained constant during a 5-year follow-up period. While primary brain lymphomas comprised only 9% of NHL diagnosed at the time of AIDS, they comprised 38% of NHL diagnosed after AIDS (p < 0.001). The prognosis for patients with NHL at AIDS diagnosis was poor with a median survival of 5 months. A diagnosis of primary brain lymphoma was uniformly associated with a poor outcome. It is concluded that the probability of developing NHL in late stage HIV infection is lower than previously anticipated from the results of small studies on patients receiving long-term anti-retroviral therapy.
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PMID:HIV-related non-Hodgkin's lymphoma among European AIDS patients. AIDS in Europe Study Group. AIDS in Europe Study Group. 758 42

A polymerase chain reaction (PCR) assay for the detection of Epstein-Barr virus (EBV) sequences in various clinical samples, especially peripheral blood leukocytes (PBL) and serum, was carried out and the results obtained were compared with specific EBV serology. One hundred seventy patients were enrolled in the study: 89 healthy blood donors, 22 asymptomatic patients, 36 individuals with primary EBV infection (including 19 patients with infectious mononucleosis [IM]), 22 HIV-infected subjects (including 4 with hairy oral leukoplakia, 3 with central nervous disorders, and 15 with non-Hodgkin's lymphoma). All the serum samples from the healthy blood donors were negative. In patients with IM and in AIDS-non Hodgkin's lymphoma (ARNHL), PCR was strongly positive in leukocytes (> 2,000 genome equivalents/10(4) cells), which was correlated with detectable amounts of EBV DNA in serum. The overall positivity rate of PCR in serum was 58.8%, 68%, and 73% of cases for non-IM primary EBV infections, IM, and ARNHL, respectively. In two cases of EBV primary infection, the viral DNA was detected in serum, respectively 1 month and 2 months before IgM positivity and IgG rise. In one case of ARNHL followed up for several months, PCR (viral load of 2,000 genome equivalents/10(4) cells) became positive concurrently with appearance of lymphoma. In immunocompromised individuals, PCR EBV, if carried out in larger prospective studies, could be considered as a tumor marker, useful for predicting EBV-driven lymphoma and follow-up therapy.
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PMID:Measurement by the polymerase chain reaction of the Epstein-Barr virus load in infectious mononucleosis and AIDS-related non-Hodgkin's lymphomas. 762 9

In the West, Kaposi's sarcoma and non-Hodgkin's lymphoma have been closely associated with HIV-induced immunosuppression. To date, however, there has been no published account of the impact of HIV infection upon malignancies prevalent in Africa where the HIV epidemic is widespread. The authors describe the pattern of malignant disorders among adult indigenous Zambians over the period 1980-89 in the attempt to discern the impact of HIV infection upon the prevailing malignancies. Histopathological and hematology records of 7836 neoplasms seen during 1980-89 at the University Teaching Hospital in Lusaka, Zambia, were analyzed. The crude incidence rate of each malignancy per 100,000 adults per year was calculated and the patterns of malignancies compared for the periods 1980-83 and 1984-89. The latter period corresponds to the advent of the HIV epidemic. Carcinoma of the cervix, Kaposi's sarcoma, bladder carcinoma, hepatoma, lymphoma, and carcinoma of the breast were the six most commonly observed tumors, occurring, respectively, among 19.6%, 7%, 6.3%, 5.8%, 4.6%, and 4.4% of cases. The crude incidence rates of Kaposi's sarcoma and carcinoma of the breast increased significantly during the last six years of the study period, with nodal KS exhibiting the most significant rise from a crude incidence rate of 0.25 per 100,000 adults per year during 1980-83 to 1.11 during 1984-89. In contrast to findings from Europe and the US, no significant increase in non-Hodgkin's lymphoma was detected in Zambia following the arrival of the HIV epidemic.
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PMID:Pattern of adult malignancies in Zambia (1980-1989) in light of the human immunodeficiency virus type 1 epidemic. 763 27

Epstein-Barr virus (EBV) has been implicated in the pathogenesis of a variety of lymphoproliferative disorders (LPDs) including endemic Burkitt's lymphoma, Hodgkin's disease (HD), HIV-associated non-Hodgkin's lymphomas (NHLs), and LPDs arising in immunosuppressed transplant patients. More recently, EBV has been associated with Ki-1-positive anaplastic large cell lymphoma (ALCL), a recently described NHL that shares with HD expression of the CD30 antigen Ki-1. Because EBV has been shown to induce Ki-1 expression in vitro, and ALCL has been diagnosed in patients with prior or concurrent HD or NHL, it has been proposed that EBV may mediate progression of a "primary" lymphoma to a "secondary" ALCL. We report a case in which an AIDS-associated, Ki-1-negative, large-cell immunoblastic lymphoma progressed to a Ki-1 positive ALCL. Analysis of the immunoglobulin heavy chain locus revealed a clonal relationship between these morphologically and immunophenotypically distinct tumors. Although EBV was absent from the original large-cell immunoblastic lymphoma as assessed by in situ hybridization for EBV-encoded small RNA1 (EBER1), polymerase chain reaction for EBNA-1, immunocytochemistry for latent membrane protein 1, and Southern blot hybridization for EBV terminal repeat sequences, all for techniques confirmed the presence of EBV in the secondary ALCL. Moreover, analysis of EBV terminal repeat sequences indicated that the ALCL resulted from expansion of a single EBV-infected clone. These data suggest that EBV may mediate progression of NHL to Ki-1-positive ALCL, and that in some instances, EBV may be involved in the later stages of clonal progression of NHL.
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PMID:Epstein-Bar virus and progression of non-Hodgkin's lymphoma to Ki-1-positive, anaplastic large cell phenotype. 767 77

Recent studies showed that patients with non-Hodgkin's lymphoma (NHL) with human immunodeficiency virus type 1 (HIV-1) infection may benefit from an intensive chemotherapeutic regimen. We report on our experience in the treatment of NHL-associated HIV-1 infection, with excellent prognostic factors, with MACOP-B regimen.
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PMID:MACOP-B chemotherapy for the treatment of high-grade lymphomas in patients with HIV-1 infection. 768 65

The occurrence of HIV associated non-Hodgkin's lymphoma (NHL) is a well recognized event. HIV associated Hodgkin's disease (HD) has also been observed. A unique patient with both entities is described. The patient was a 29 year old homosexual male who developed clinical IIA nodular sclerosis HD in 1985. He was HIV + with CD4/CD8 = 0.2 and his sister had HD 20 years earlier. He received MOPP and had a complete response. In October 1988 he developed weight loss with an abdominal mass and biopsy revealed diffuse small non-cleaved NHL, with bone marrow involvement. This was his first AIDS associated illness. Probes identified clonally rearranged DNA fragments in the J region of IgH chains and clonal rearrangements in the c-myc gene were also observed but EBV sequences could not be demonstrated. He was treated with m-BACOD but died in March 1989. His course was not complicated by opportunistic infection. Possible etiologies for the HD include his HIV status or shared sibling environment. The development of the NHL may have resulted from HIV infection and/or secondary to his treatment for HD. The relationship between the two lymphomas is uncertain and factors other than HIV exposure and its immune dysfunction may have been causal.
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PMID:Hodgkin's disease and non-Hodgkin's lymphoma in an HIV positive patient. 768 28

Lymph node and bone marrow trephine biopsies of seventy two consecutive cases of non-Hodgkin's lymphoma occurring among black Zimbabweans were reviewed to determine bone marrow involvement. The bone marrow was involved in 23.6% of patients but the proportion of bone marrow positive cases was highest in low grade lymphomas, though these were the least common type of lymphoma encountered. Cells infiltrating the marrow showed high degree of concordance with corresponding lymph node histology. Low grade lymphomas (CLL excluded) had a predominantly diffuse pattern of marrow involvement while intermediate and high grade lymphomas had nearly equal proportions with diffuse and focal patterns. Bone-marrow involvement did not make a significant difference to the staging of non-Hodgkin's lymphoma as most cases not involving the marrow also presented with advanced disease. Mean age of patients was negatively correlated with histological grade but was not related to bone marrow involvement. Central nervous system involvement occurred mostly in the high grade lymphomas and was proportionately distributed between bone marrow positive and negative cases. 40% of non-Hodgkin's lymphoma were associated with HIV infection but HIV-associated lymphoma surprisingly very rarely infiltrated the bone marrow.
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PMID:Bone marrow involvement in non-Hodgkin's lymphoma in Zimbabwe. 770 45


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