Decrease in Epstein–Barr virus-positive AIDS-related lymphoma in the era of highly active antiretroviral therapy

• Published in: Microbes and infection 2006-04, Vol.8 (5), p.1301-1307
• Main Authors: Hishima, Tsunekazu, Oyaizu, Naoki, Fujii, Takeshi, Tachikawa, Natsuo, Ajisawa, Atsushi, Negishi, Masayoshi, Nakamura, Tetsuya, Iwamoto, Aikichi, Hayashi, Yukiko, Matsubara, Daisuke, Sasao, Yuki, Kimura, Satoshi, Kikuchi, Yoshimi, Teruya, Katsuji, Yasuoka, Akira, Oka, Shinichi, Saito, Kiyoshi, Mori, Shigeo, Funata, Nobuaki, Sata, Tetsutaro, Katano, Harutaka
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; AIDS-related lymphoma; Antiretroviral Therapy, Highly Active; Biological and medical sciences; Burkitt Lymphoma - epidemiology; Burkitt's lymphoma; Child; Diffuse large B cell lymphoma; Epstein-Barr virus; Epstein-Barr Virus Infections - epidemiology; Epstein-Barr Virus Infections - virology; Female; Fundamental and applied biological sciences. Psychology; Herpesvirus 4, Human; Highly active antiretroviral therapy; HIV Infections - complications; HIV Infections - drug therapy; Human herpesvirus 8; Human immunodeficiency virus; Human viral diseases; Humans; Incidence; Infectious diseases; Japan - epidemiology; Lymphoma, AIDS-Related - epidemiology; Lymphoma, AIDS-Related - virology; Lymphoma, B-Cell - epidemiology; Lymphoma, Large B-Cell, Diffuse - epidemiology; Male; Medical sciences; Microbiology; Middle Aged; Miscellaneous; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Virology
• ISSN: 1286-4579; 1769-714X
• DOI: 10.1016/j.micinf.2005.12.012

Recent introduction of highly active antiretroviral therapy (HAART) is reported to have reduced the incidence of lymphoma among HIV-infected individuals. A clinicopathological study was performed on 86 AIDS-related lymphoma patients who were treated in Tokyo area from 1987 to 2005. The incidence of lymphoma detected by autopsy was 27% (53 cases/198 autopsies). Diffuse large B cell lymphoma was the most predominant histological subtype throughout the period (78%). Burkitt's lymphoma (BL) increased from 2% in the pre-HAART era (before end-1997) to 13% in the HAART era, whereas incidence of BL did not vary between HAART users and non-users. Epstein–Barr virus (EBV)-positive lymphoma decreased from 88% in the pre-HAART era to 58% in the HAART era, but did not differ significantly between HAART users (73%) and non-users (74%). Nodal involvement of lymphoma increased from 14% in the pre-HAART era to 50% in the HAART era; however, central nervous system involvement decreased from 62 to 38%. Kaposi's sarcoma-associated herpesvirus infection was rare (4%) among all cases. These data suggest that HAART might play a partial role in these changes, and the alteration in immunological backgrounds, such as EBV prevalence, is suggested as another leading cause of these changes in Japanese AIDS-related lymphoma.