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

Patients with HIV infection, like immunosuppressed transplant recipients, are at high risk for the development of non-Hodgkin's lymphoma. These are high-grade lymphomas of B cell origin. Most patients present with advanced extralymphatic disease, and primary lymphoma of the central nervous system has frequently been reported. The cause of the non-Hodgkin's lymphomas in the setting of HIV infection remains unclear. In contrast to those lymphomas observed in transplant recipients, Epstein-Barr virus DNA sequences have been identified in a minority of AIDS-associated lymphomas. Response to therapy in these patients has been disappointing. Response rates to chemotherapy have been lower than those observed in other lymphoma patients, and treatment has been complicated by lack of adequate bone marrow reserve and the occurrence of frequent opportunistic infections. Survivals have been short. Good performance status and absence of a prior AIDS diagnosis are important predictors of response and survival. Although Hodgkin's disease has been observed in HIV-infected patients, epidemiologic data are not suggestive of a direct causal relationship. Hodgkin's disease in this setting is characterized by poor prognosis histologic pattern, advanced disease, and median survivals of less than 1 year.
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PMID:AIDS-associated lymphomas. 306 May 34

This work, intended primarily for dentists, provides detailed information on the mechanism of action of the AIDS virus, its epidemiology and most common routes of infection, the clinical manifestations of HIV infection, and related oral lesions of relevance to the dentist. The work also recommends ways in which dentists can aid in diagnosis, avoid contaminating patients, and avoid being infected themselves by seropositive patients. The article begins by describing retroviruses and their mode of action and then focuses on the pathogenic mechanism of the HIV virus, which preferentially attacks T4 helper lymphocytes. The lymphocytes are destroyed by the viruses multiplying in their interiors. The decline in the number of T4 lymphocytes results in diminished capacity of the immune system to respond, favoring in turn the appearance of certain tumors and opportunistic infections that eventually prove fatal. The virus may also affect cells of the central nervous system, producing dementia and other disorders. Although AIDS was initially observed primarily in male homosexuals and drug addicts in the US and Europe, it has had a relatively even sex ratio in Africa, where few victims have been homosexuals or drug addicts. The virus is now found in most of the world's countries and is known to be spread primarily through sexual contact. Other routes of transmission are by contaminated hypodermic needles, prenatal infection, and infected blood transfusions. There is still no good evidence that saliva can be a route of contamination. Lesions of the oral cavity that indicate immune deficiency include Candidiasis, gingivostomatitis, necrosing ulcer, Histoplasmosis, Herpes simplex, papillomas and condylomas, Leukoplasia vellosa, Kaposi's sarcoma, some cancers, and non-Hodgkin's lymphoma. European and American studies indicate that 75% of AIDS patients have oral or oral-esophageal candidiasis, which can occur in 3 forms. Most of these oral manifestations are very rare in the general population. The dentist should wear protective clothing to prevent direct transmission and should carefully discard or disinfect used materials and supplies. Tools and the work area should be carefully decontaminated after each patient is seen.
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PMID:[Human acquired immunodeficiency syndrome (AIDS)]. 333 54

For the first time the presence of a consistent number of malignant lymphomas (95 patients with non-Hodgkin's lymphoma and 35 with Hodgkin's disease) among persons with human immunodeficiency virus infection has been documented in Europe. In contrast to American patients with malignant lymphomas, who were reported to be predominantly homosexuals, the Italian patients were mostly iv drug abusers. Patients with non-Hodgkin's lymphomas had an increased incidence of high-grade subtypes and presented an advanced stage with frequent CNS (25 patients) but not anorectal or oral involvement. Patients with Hodgkin's disease had an increased incidence of mixed cellularity and lymphocytic depletion subtypes and stage III and IV disease. The occurrence of malignant lymphomas was correlated with a poor prognosis: median survival in patients with non-Hodgkin's lymphomas was only 4 months, while in patients with Hodgkin's disease it was 15 months.
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PMID:Malignant lymphomas in patients with or at risk for AIDS in Italy. Italian Cooperative Group for AIDS-Related Tumors. 339 45

The extent to which the epidemic of human immunodeficiency virus (HIV) infection has changed the descriptive epidemiology of cancers other than Kaposi's sarcoma is unknown. This study, based on cancer surveillance data (New York State Cancer Registry) and mortality statistics (New York City death certificates), examines changes in the epidemiology of another HIV-related malignancy, non-Hodgkin's lymphoma. Since the beginning of the epidemic of acquired immunodeficiency syndrome (AIDS), there have been large increases in non-Hodgkin's lymphoma among the population at highest risk of HIV infection, never married males, aged 25-54 years, who live in neighborhoods with high AIDS mortality. In this group between 1980 and 1984, age-adjusted incidence increased from 12.3 to 31.8 per 100,000, proportional cancer incidence increased from 6.4 to 20.2% and, between 1980-1981 and 1984-1985, biannual mortality increased from 4.2 to 13.5 per 100,000 (all trends p less than 0.01). These results demonstrate the value of using routinely-collected cancer and mortality surveillance data to study HIV-related malignancies.
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PMID:Changes in the epidemiology of non-Hodgkin's lymphoma associated with epidemic human immunodeficiency virus (HIV) infection. 342 Dec 37

High grade malignant non-Hodgkin's lymphoma (NHL) was the presenting manifestation of the acquired immunodeficiency syndrome (AIDS) in 3/81 reported cases of AIDS in Denmark (by April 2, 1986). Asymptomatic HIV infection, 1 and 5 yr prior to the onset of lymphoma, was documented in 2 cases. 1 patient became infected by Factor VIII treatment, 2 were male homosexuals. 2 patients had an uncommon tumour presentation in the oral cavity, 1 patient presented with an abdominal mass. The histologic subtypes were immunoblastic (2), and small noncleaved cell, Burkitt's (1). Helper/suppressor T-cell ratio was decreased at onset of lymphoma in 2 cases. All 3 patients have died, 4, 6, and 24 months after diagnosis of NHL. Only 1 patient died of NHL, 1 died of an unclassified pneumonia and the third developed progressing supranuclear HIV-associated polyneuropathy without evidence of CNS lymphoma. Thus, high grade malignant B-cell NHL is a regular initial manifestation of AIDS, and may develop after years of asymptomatic HIV infection.
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PMID:Human immunodeficiency virus (HIV) associated non-Hodgkin's lymphomas in Denmark: report of three cases. 365 75

Infection with the human immunodeficiency virus (HIV) leads to selective depletion of the helper/inducer lymphocyte subset and a subsequent state of acquired cellular immunodeficiency. Simultaneously, evidence of B-cell hyper-activity may exist. A subset of patients infected with HIV demonstrates a syndrome of persistent generalized lymphadenopathy (PGL). Lymph node biopsies reveal benign reactive changes with a pattern of florid follicular hyperplasia. A polyclonal hypergammaglobulinemia reflects humoral immune dysfunction. Patients with PGL are similar to those with full-blown AIDS with regards to demographics, immune and virologic studies. Our prospective natural history study of PGL patients initiated in November 1981 reveals a 15% rate of evolution to AIDS in the 200 patient cohort. Factors associated with increased risk of transformation to AIDS include severity of constitutional symptoms, shrinking adenopathy, oral candidiasis or viral hairy leukoplakia, peripheral cytopenias, elevated erythrocyte sedimentation rate or an antecedent episode of herpes zoster. Therapeutic interventions to prevent evolution to AIDS in high risk subsets of lymphadenopathy patients have been investigated. In addition to benign B-cell proliferation associated with HIV infection, malignant lymphomas have also been diagnosed in 29 patients in AIDS risk groups in our clinic population. All patients were male; 26 homosexuals, 2 IV drug abusers and 1 multiply transfused sickle cell anemia patient. Seven patients had antecedent PGL. Non-Hodgkin's lymphoma was diagnosed in 19 patients. Histologies were predominantly diffuse undifferentiated or large cell. Eleven patients were Stage IV at diagnosis. Of 10 patients with mixed cellularity Hodgkin's disease, 7 were Stage IV-B at presentation. Extranodal disease was frequent in patients with lymphomas. Fourteen patients lacked peripheral lymphadenopathy. Response to chemotherapy was good, but complicated by prolonged marrow suppression and development of AIDS-related opportunistic infections. Median survival was 7 months. Laboratory studies investigating the possible role of lymphotropic retroviruses in the development of AIDS-related lymphomas revealed that serum from all patients with high grade non-Hodgkin's lymphoma contained antibodies to HIV and that the majority also expressed antibodies to HTLV-I. This degree of seroreactivity to HTLV-I and HIV was characteristic only of lymphoma patients as sera from only 10 - 15% of AIDS and ARC patients in San Francisco had similar findings.
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PMID:AIDS-related benign lymphadenopathy and malignant lymphoma: clinical aspects and virologic interactions. 382 9

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


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