EBV, HHV8 and HIV in B cell non Hodgkin lymphoma in Kampala, Uganda

Abstract

BackgroundB cell non Hodgkin lymphomas account for the majority of lymphomas in Uganda. The commonest is endemic Burkitt lymphoma, followed by diffuse large-B-cell lymphoma (DLBCL). There has been an increase in incidence of malignant lymphoma since the onset of the HIV/AIDS pandemic. However, the possible linkages of HHV8 and EBV to the condition of impaired immunity present in AIDS are still not yet very clearly understood.Objectives1. To describe the prevalence of Epstein-Barr virus, Human Herpes virus 8 and Human Immunodeficiency Virus-1 in B cell non Hodgkin lymphoma biopsy specimens in Kampala, Uganda.2. To describe the histopathology of non Hodgkin lymphoma by HIV serology test result in Kampala, UgandaMethodTumour biopsies specimens from 119 patients with B cell non Hodgkin lymphoma were classified according to the WHO classification. Immunohistochemistry was used for detection of HHV8 and in situ hybridization with Epstein Barr virus encoded RNA (EBER) for EBV. Real time and nested PCR were used for the detection of HIV.The patients from whom the 1991-2000 NHL biopsies had been taken did not have HIV serology results therefore 145 patients biopsies where serology results were available were used to describe the association of HIV with non Hodgkin lymphoma type during 2008-2009.ResultsIn this study, the majority (92%) of the Burkitt lymphomas and only 34.8% of the diffuse large B cell lymphomas were EBV positive. None of the precursor B lymphoblastic lymphomas or the mantle cell lymphomas showed EBV integration in the lymphoma cells.None of the Burkitt lymphoma biopsies had HIV by PCR. Of the 121 non Hodgkin B cell lymphoma patients with HIV test results, 19% had HIV. However, only 1(0.04%) case of Burkitt lymphoma had HIV. All the tumours were HHV8 negative.ConclusionsThe majority of the Burkitt lymphomas and two fifths of the diffuse large B cell lymphomas had EBV. All the tumours were HHV8 negative. Generally, the relationship of NHL and HIV was weaker than what has been reported from the developed countries. We discuss the role of these viruses in lymphomagenesis in light of current knowledge.

Pediatric Non-Hodgkin Lymphomas: First Report from Central Africa

“…The high incidence of Burkitt's lymphoma in tropical Africa is well known [16,17,[21][22][23]. In contrast, BL was found less than 40% of childhood NHL in western countries [24,25].…”

“…According to GLOBOCAN 2008 estimation rates, 26,224 cases of NHLs occur each year in Africa [2]. In the African pediatric population, the NHLs represents 22.0% of all childhood cancer in this part of the world [3]. Great progress has been made in the care of children with NHL in recent decades.…”

Epstein-Barr virus-positive diffuse large B-cell lymphoma association is not only restricted to elderly patients

“…In fact, our group had previously found in an Argentinean cohort an association between EBV and pediatric DLBCL showing similar or even higher frequencies than the adult counterpart, 27 in agreement with few more studies in pediatric NHL from developing countries. [41][42][43] Although the number of patients is low for a comparison, the similarities between both groups strongly suggest that the age cutoff established should be revised. Concerning other demographical aspects, several EBV associated malignancies displays a clear male prevalence.…”

Human Herpes Virus-8 Infections among Subjects with Human Immunodeficiency Virus Infection and Normal Healthy Individuals in India

“…The HHV-8 viremia reported prior to HAART was very high [3]. However, there are several reports on nondetection of HHV-8 among HIV-1-infected individuals from Japan and Uganda [18,19]. …”