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Characterization of Lymphomas in a High Prevalence HIV Setting

Mantina, Hamakwa MD*; Wiggill, Tracey M MBBch, MMed (Haem)*; Carmona, Sergio MBBch; Perner, Yvonne MBBch, FCPath (Anat path); Stevens, Wendy S MBBch, MMed (Haem), FCPath (Haem)*

JAIDS Journal of Acquired Immune Deficiency Syndromes: April 15th, 2010 - Volume 53 - Issue 5 - p 656-660
doi: 10.1097/QAI.0b013e3181bf5544
Brief Report: Epidemiology and Social Science

Background: HIV infection has been associated with an increased risk of malignancy, both AIDS defining and non-AIDS defining.

Methods: This study presents a detailed pathological description of newly diagnosed lymphomas in Johannesburg, South Africa (January 2004 and December 2006). The review coincides with introduction of combination antiretroviral therapy.

Results: One thousand eight hundred and ninety-seven new lymphoproliferative disorders were referred to the Charlotte Maxeke Johannesburg Academic Hospital. B-cell non-Hodgkin lymphoma accounted for 83%, T-cell non-Hodgkin lymphoma 3.5%, and Hodgkin lymphoma 7% of cases. The overall prevalence of HIV infection was 37% (n = 709). Diffuse large B-cell lymphoma (21%; n = 401) was the most common lymphoma. HIV prevalence ranged from an absence in follicular or mantle cell lymphoma to a low prevalence in diseases like small lymphocytic lymphoma/chronic lymphocytic leukemia (4%) and pre-B/common ALL (5%) to a high prevalence in diffuse large B-cell lymphoma (80%), Burkitt lymphoma/leukemia (86%), and primary effusion lymphoma (100%).

Conclusions: This study provides a baseline for monitoring the impact of HIV and management thereof on lymphoma trends. The high prevalence of HIV in certain lymphoma categories emphasizes the need for capacity to diagnose and manage dual conditions. This study highlights the need for strengthening of cancer registries within South Africa and the region.

From the *Department of Molecular Medicine and Haematology, Johannesburg, South Africa; and †Department of Anatomical Pathology, University of the Witwatersrand and National Health Laboratory Service, Johannesburg, South Africa.

Received for publication June 19, 2009; accepted August 31, 2009.

Conflict of interest: None.

Presented at PathTrack conference in Cape Town South Africa, July 2008, CROI Montreal, 2009.

Correspondence to: Wendy Stevens, MBBch, MMed (Haem), FCPath (Haem), Room 3B22, Wits Medical School, 7 York Rd, Parktown, Johannesburg 2000, South Africa (e-mail: wendy.stevens@nhls.ac.za).

© 2010 Lippincott Williams & Wilkins, Inc.