Lymphomas are a heterogeneous group of malignant haemopathies characterized by ganglionic and extra ganglionic infiltration of lymphoid cells. Their occurrence during the HIV infection had a specific clinical, therapeutic and evolutionary particularities.
The aims of our study was to evaluate and compare the clinical, therapeutic and evolutionary aspects of HIV and none HIV patients.
It was a descriptive and analytical case-control study of patients with lymphoma followed at the department of clinical hematology at Yopougon Teaching Hospital from January 2014 to October 2016. The histology and immunohistochemistry was the diagnosis’ means to retain the diagnostic of lymphoma. The HIV test was performed by Western Blood. The variables of our study were the epidemiological, clinical, therapeutic and evolutionary aspects. Statistical analyzes were performed with épi info 351 and SPSS. The statistical test used was the ki2 test.
We collected 40 cases of lymphoma including 15 cases of HIV positive and 25 cases negative. The average age was 47 years with extremes of 27 and 65 years old. There was more male than female with a sex ratio of 2 for HIV positive and 3.16 for HIV negative. The reasons of consultation were dominated by polyadenopathies. The WHO performans status was stage 2 for 53.33% of HIV-positive patient and stage 1 for 68% of HIV-negative patients. Among HIV-positive patients, 60% knew their status before the discovery of lymphoma and 53% already had opportunistic infections dominated by digestive and genital candida infection in 50% of cases. We noted 80% of aggressive lymphoma in the HIV-positive patients with 26.6% Burkitt's lymphoma versus 68% aggressive lymphoma in the HIV-negative patient. The lymph node localization was the most common with 66.6% for HIV-positive patients and 84% for HIV-negative patients. The breast localization was particularity observed with HIV positive patient. 86.6% of HIV-positive patients have a bad prognosis against 16% for the HIV-negative patients. For the treatment, the CHOP 21 protocol was the most used in both groups with 66.8% for HIV-positive patients and 60% for HIV-negative patients. The compliance was poor at 77% with HIV-positive patients. The Median survival was 33 and 11 months, respectively, in the HIV-negative and HIV-positive patients.
The prognosis of lymphoma with HIV remains pejorative in our country because often unknown before the diagnosis of lymphoma.