Epidemiological and biological study of acquired immunodeficiency syndrome-related lymphoma in the County of Los Angeles: preliminary results.
A population-based case control study of intermediate- and high-grade lymphoma in the County of Los Angeles, CA, was initiated in 1989. Human immunodeficiency virus (HIV)-positive lymphoma patients are compared to HIV-negative lymphoma patients, to HIV-positive controls with acquired immunodeficiency syndrome but without lymphoma, and to HIV-positive asymptomatic individuals. The HIV-negative lymphoma cases are compared to neighborhood controls, who are matched in terms of age, sex, race/ethnicity, and socioeconomic status. All cases are reviewed for pathology by a single group of pathologists. All cases and controls are studied for HIV, Epstein-Barr virus (EBV), and human herpesvirus 6 antigens and antibodies. Tissues from HIV-positive and -negative cases are studied for immunoglobulin gene rearrangement, presence of EBV and HIV, c-myc oncogene rearrangements, and karyotypic analysis. To date, with 294 lymphoma cases and 181 control cases interviewed, high-grade lymphoma has been diagnosed in 82% of the HIV-positive cases versus 40% of the HIV-negative cases (P = 0.001). Although elevated titers of EBV-viral capsid antigen were demonstrated in 82% of HIV-positive versus 50% of HIV-negative lymphoma cases, the geometric mean titer of EBV-viral capsid antigen is similar among HIV-positive lymphoma cases and HIV-positive controls. The geometric mean titer of human herpesvirus 6 antibodies was similar in HIV-positive and HIV-negative lymphoma cases and in the control populations. Monoclonality was demonstrated in all cases of lymphoma. EBV genome was demonstrated within lymphoma DNA in 68% of HIV-positive and 15% of HIV-negative lymphoma cases. Further study will be required to elucidate the full mechanisms of pathogenesis of the acquired immunodeficiency syndrome-related lymphomas.
Levine
A M
AM
Department of Internal Medicine (Hematology), University of Southern California School of Medicine, Los Angeles 90033.
Shibata
D
D
Sullivan-Halley
J
J
Nathwani
B
B
Brynes
R
R
Slovak
M L
ML
Mahterian
S
S
Riley
C L
CL
Weiss
L
L
Levine
P H
PH
D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015321:Gene Rearrangement; D006679:HIV Seropositivity / Q000453:epidemiology; D004854:Herpesvirus 4, Human / Q000235:genetics; D015654:Herpesvirus 6, Human; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D016483:Lymphoma, AIDS-Related / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D016393:Lymphoma, B-Cell / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology; D008875:Middle Aged