Immune Reconstitution Inflammatory Syndrome and Hodgkin’s Lymphoma

Abstract

Immune reconstitution inflammatory syndrome (IRIS) is defined as a clinically significant exacerbation of known low-symptomatic serious, more often infectious diseases, in conditions of a significant increase in the level of initially low levels of CD4+ T-lymphocytes in response to highly active antiretroviral therapy (HAART) for HIV infection. Without prior etiotropic therapy for an opportunistic infection, its exacerbation with a pronounced clinical picture during HAART can be fatal for the patient. Lymphomas, including Hodgkin’s lymphoma (HL), are considered within the framework of this problem. Unlike other malignant lymphoid tumors that occur with low levels of CD4+ T-lymphocytes, HL develops with elevated levels of CD4+ lymphocytes in response to HAART in HIV-infected patients in the first months of starting antiretroviral treatment. HL was diagnosed in 8% of HIV-infected individuals without HAART. After the appointment of HAART, the frequency of HL increases to 17%. These data allow the problem of IRIS to be considered as the main one in the study of the etiology and pathogenesis of HL in HIV-infected patients.