title: Therapeutic challenges of AIDS-related non-Hodgkin's lymphoma in the United States and East Africa.
abstract: Non-Hodgkin's lymphoma (NHL) remains the second most common malignant complication in patients with human immunodeficiency virus (HIV) infection. As we enter the third decade of the acquired immunodeficiency syndrome (AIDS) epidemic, it is apparent that the evolution of antiretroviral therapy and the emergence of combination antiviral strategies have greatly affected the natural history of HIV infection and its neoplastic complications. For example, there may be a trend for declining incidence of AIDS-related lymphoma in the United States for the first time. However, in regions of the world where the burden of HIV infection is greatest, such as in East Africa, AIDS-related lymphoma is an increasing cause of morbidity and mortality. Treatment of lymphoma has evolved coincident with improvements in antiretroviral therapy. Infusional chemotherapy regimens may offer advantages over other regimens and schedules, but comparative trials have not been done. Clinical trial data are available on which to develop therapeutic strategies to treat this disease in East Africa where pragmatic approaches are needed. Both the differences in manifestations of HIV infection and the inherent difficulties in administering cytotoxic chemotherapy in this part of the world must be taken into consideration in planning therapeutic strategies. Improved understanding of the pathogenesis of HIV infection and lymphoma will likely yield improved therapeutic interventions as well.
authors: Department of Haematology and Blood Transfusion, College of Health Sciences, University of Nairobi and the Kenyatta National Hospital, Nairobi, Kenya.
authors: Mwanda W
authors: MW
authors: Otieno
authors: Cecily
authors: C
authors: Banura
authors: Edward
authors: E
authors: Katongole-Mbidde
authors: John L
authors: JL
authors: Johnson
authors: Mahmoud
authors: M
authors: Ghannoum
authors: Afshin
authors: A
authors: Dowlati
authors: Rolf
authors: R
authors: Renne
authors: Eric
authors: E
authors: Arts
authors: Christopher
authors: C
authors: Whalen
authors: Michael M
authors: MM
authors: Lederman
authors: Scot C
authors: SC
authors: Remick
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000276:immunology / Q000821:virology; D000351:Africa, Eastern / Q000453:epidemiology; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*; D015996:Survival Rate; D014481:United States / Q000453:epidemiology
chemical_list: D019380:Anti-HIV Agents