Raising Awareness of Non-Hodgkin Lymphoma in HIV-infected Adolescents

Abstract

Human immunodeficiency virus (HIV) chronically infected patients are at increased risk of developing non-Hodgkin lymphoma compared with the general population. Highly active antiretroviral therapy has had a dramatic effect on the natural history of HIV infection, reducing the incidence of acquired immunodeficiency syndrome-related non-Hodgkin lymphoma and improving overall survival. However, problems related to adherence to treatment, frequently experienced during adolescence, may increase the risk of acquired immunodeficiency syndrome-related cancers. Optimizing highly active antiretroviral therapy and monitoring noncompliant patients with persisting HIV replication should be considered by physicians who take care of these patients. We herein report 2 cases of relapsed/progressive Burkitt lymphoma in HIV vertically infected adolescents.

Cancer in adolescents and young adults living with HIV

“…Treatment outcomes were not reported. This study echoes a previous report from Italy, describing two cases of Burkitt lymphoma in AYALHIV who were chronically exposed to high-levels HIV viremia [23]. These two case series support the concerns of longer term oncogenic risk for the current generation of perinatally infected AYALHIV following prolonged viremia due to late diagnosis, and low rates of viral suppression due to previous inferior ART regimens, suboptimal dosing, non-adherence and the evolution of resistance [22].…”

Immune Activation, Inflammation, and Non-AIDS Co-Morbidities in HIV-Infected Patients under Long-Term ART

“…NADC incidence in PLWH is two times higher than in the general population, despite the use of ART [93]. In addition, in the past few years, an increase in the number of NADCs has been recorded, while ADC cases are decreasing but still reported [94,95].…”

Cancer risk in adolescents and young adults living with HIV in South Africa: a nationwide cohort study

“…18,19 For AYALWH, this is anecdotally supported by a report on two vertically infected 15year-olds in Italy who were diagnosed with Burkitt lymphoma after prolonged exposure to HIV viremia. 20 Compared to other age groups, AYALWH have higher rates of non-adherence to antiretroviral treatment and, thus, of virologic failure. 2 This may put AYALWH at particularly high risk of developing HIV-related hematologic malignancies.…”

“…We classified cancers based on the International Classification of Diseases for Oncology, 3 rd Edition (ICD-O-3), recoded for AYA. 9 We categorised cancers into the following groups 10 : leukaemia (AYA recode 01-04), non-Hodgkin lymphoma (05), Hodgkin lymphoma (06), central nervous system (CNS) and other intracranial and intraspinal neoplasms (07-16), osseous & chondromatous neoplasms (17)(18)(19)(20), Kaposi sarcoma (24), soft tissue sarcomas other than Kaposi sarcoma (21)(22)(23)25), germ cell and trophoblastic neoplasms (26)(27)(28), melanoma and skin carcinomas (29,30), carcinomas (31-48), and miscellaneous specified and unspecified neoplasms and unclassified cancers (49-56, 99). We further divided the non-Hodgkin lymphomas into their most common subtypes: Burkitt lymphomas (ICD-0-3 morphology code 9687) and diffuse large B-cell lymphomas (ICD-0-3 morphology code 9680 or 9684), with a separate category for other non-Hodgkin lymphomas.…”