The Impact of Human Immunodeficiency Virus Infection (HIV) on Lymphoma in South Africa

Patel, Moosa; Philip, Vinitha; Touzani, Omar; Turton, Dianne; Candy, G.; Lakha, Atul; Pather, Sugeshnee

doi:10.4236/jct.2015.66057

Cited by 21 publications

(28 citation statements)

References 27 publications

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“…In line with previous reports, 1,4,17,21,24 most PBLs occurred in the fourth decade of life, with a single paediatric nasopharyngeal tumour being seen in an HIV-positive 9-year-old male. Paediatric PBL is infrequent; three HIV-positive patients aged between 9 and 11 years, showing extraoral disease (orbital, nasal, and scalp) and positive for EBER mRNA, were previously reported in our institution.…”

Section: Discussionsupporting

confidence: 92%

“…The incidence of non‐Hodgkin's lymphoma in HIV‐positive individuals pre‐ART in North America and western Europe was 60‐ to 200‐fold higher than in a matched HIV‐negative population . This risk has not significantly decreased with ART in South Africa . Worldwide, PBL and DLBCL are reported in 3% and 50% of HIV‐related lymphomas, respectively .…”

Section: Discussionmentioning

confidence: 99%

“…16 This risk has not significantly decreased with ART in South Africa. 4,17 Worldwide, PBL and DLBCL are reported in 3% and 50% of HIV-related lymphomas, respectively. 18 In South Africa, PBL is the most frequently diagnosed oral lymphoma (31.6%), and 87% of cases are HIVassociated.…”

Section: Discussionmentioning

confidence: 99%

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Extraoral plasmablastic lymphomas in a high human immunodeficiency virus endemic area

et al. 2019

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Aims Plasmablastic lymphoma (PBL) occurs mainly in immunocompromised individuals, usually secondary to human immunodeficiency virus (HIV) infection. It classically occurs intraorally, but has been described in extraoral locations. The aim of this study was to define the immunophenotype and Epstein–Barr virus (EBV) status in a large single‐centre cohort of extraoral PBL (EPBL) in South Africa, a high‐prevalence HIV setting. Methods and results This retrospective study of 45 EPBLs included patients' age, gender, race, HIV status, and site. Cases were reviewed histologically, and classified morphologically as pure plasmablastic or plasmablastic with plasmacytic differentiation, and assessed immunohistochemically with antibodies against CD45, CD20, CD79a, PAX5, CD138, MUM1/IRF4, BLIMP1, VS38c, Ki67, bcl‐6, CD10, cyclin D1, and human herpesvirus‐8, by the use of standard automated procedures. EBV was assessed by the use of chromogenic in‐situ hybridisation. Tumours were assessed with a fluorescence in‐situ hybridisation (FISH) MYC break‐apart probe. Twenty‐seven PBLs showed pure plasmablastic morphology, and 18 showed plasmacytic differentiation. The male/female ratio was 1.5:1. The anus was the favoured extraoral site (31.1%), followed by lymph nodes (15.6%). All 29 patients with known HIV status were HIV‐positive. The immunohistochemical profile recapitulated that reported for oral PBLs and EPBLs in HIV‐positive and HIV‐negative patients. EBV was positive in 92.5% of PBLs. FISH analysis showed MYC rearrangement in 48% of cases. Conclusion This study showed a strong association of EPBLs with HIV and EBV infection, similarly to the previously described oral PBL. The strong EBV association together with other clinicopathological parameters and an immunohistochemical profile that includes CD45, CD20, MUM1/IRF4, CD138 and Ki67 may be used in distinguishing PBL from diffuse large B‐cell lymphoma and plasma cell myeloma.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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Extraoral plasmablastic lymphomas in a high human immunodeficiency virus endemic area

et al. 2019

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“…The high proportion of BL in HIV+ NHL mirrors that seen at another academic site in the Western Cape in an overlapping time period. 14 These findings contrast with those from Gauteng, where DLBCL was more common than BL in the HIV+ group in a similar time frame, [11][12][13] and comparatively higher HIV seroprevalence figures and lower CD4 counts were reported. 13 This variation may reflect regional differences in HIV seroprevalence, CD4 counts at presentation and ART access.…”

Section: Discussionmentioning

confidence: 88%

The utility of bone marrow sampling in the diagnosis and staging of lymphoma in South Africa

Phillips

Opie

2018

Int J Lab Hematology

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In the South African public sector, high HIV prevalence leads to a different lymphoma pathology profile from the developed world. High BMI rates are encountered. Here, and in similar resource-constrained settings, international lymphoma staging guidelines can be logistically challenging and unaffordable. BMB remains useful in the staging and diagnosis of lymphoma. Unilateral sampling with a processed trephine length of at least 26 mm is recommended.

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“…[2] This rise in incidence largely seems to be linked to HIV infection. Several studies conducted at SA tertiary hospitals have described the prevalence of HL as 7 -17% of all lymphomas, [3][4][5][6] 8 -27% of head and neck lymphomas, [7,8] 9% of lymph node biopsies and 4% of HIV-related malignancies [9] presenting at the respective hospitals. HIV seropositivity in these cases ranged between 8% and 67%.…”

Section: Researchmentioning

confidence: 99%

Incidence of Hodgkin lymphoma in HIV-positive and HIV-negative patients at a tertiary hospital in South Africa (2005 - 2016) and comparison with other African countries

et al. 2018

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Absolute numbers of cases of HL at our centre have increased since the roll-out of antiretroviral therapy (ART) to the public sector. The recent change in policy to make ART available to all HIV-positive patients independent of CD4+ count suggests that patients will survive longer and are therefore at increased risk of developing HL. We anticipate that numbers of HL cases will increase or remain high in the coming years, and we need to prepare for this.

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The Impact of Human Immunodeficiency Virus Infection (HIV) on Lymphoma in South Africa

Abstract: Human immunodeficiency virus (HIV) infection is endemic in

Cited by 21 publications

References 27 publications

Extraoral plasmablastic lymphomas in a high human immunodeficiency virus endemic area

Extraoral plasmablastic lymphomas in a high human immunodeficiency virus endemic area

The utility of bone marrow sampling in the diagnosis and staging of lymphoma in South Africa

Incidence of Hodgkin lymphoma in HIV-positive and HIV-negative patients at a tertiary hospital in South Africa (2005 - 2016) and comparison with other African countries

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