[Lymphoma genesis in the context of HIV infection].
The incidence of lymphomas is high among HIV infected patients. These lymphomas are non-Hodgkin's lymphoma (NHL) in 70% of cases and Hodgkin's disease (HD) in 30% of cases. Their localization is often extra-nodal with early dissemination. B-cell high grade NHL predominates. The most frequent histological types are diffuse large B-cell lymphoma (30 to 40%) and Burkitt's lymphoma (40 to 50%). Other histological types are low-grade B-cell lymphoma, polymorphic B cell lymphoma and primary effusion lymphoma. Three main factors are predominant in HIV-related lymphomagenesis: cellular immunodeficiency, oncogene viruses (Epstein-Barr and HHV8) and molecular lesions. HIV-related cellular immunodeficiency leads to the increase of EBV infected B-cells and to the diminution of antitumor immunity. Clonal EBV genome is found in lymphoma cells in 30 to 70% of cases of HIV-related NHL. It expresses oncogenic proteins including LMP-1 which behaves like an activated CD40. It induces the expression of intra-cellular genes which stimulate cell growth and inhibit apoptosis. Cytogenetic and molecular lesions are not specific to HIV-related NHL or to histological subtypes. A better knowledge of these mechanisms should lead to the development of specific targeted treatments (antiviral, cytotoxic anti-EBV lymphocytes, cell cycle regulators).
Besson
Caroline
C
Unité 550 Génétique humaine des maladies infectieuses, Faculté Necker, 156, rue de Vaugirard, 75015 Paris.
Raphaël
Martine
M
D000328:Adult; D002051:Burkitt Lymphoma / Q000453:epidemiology / Q000209:etiology / Q000235:genetics / Q000276:immunology; D004260:DNA Repair; D006678:HIV / Q000235:genetics / Q000276:immunology; D006566:Herpesviridae Infections / Q000150:complications; D004854:Herpesvirus 4, Human; D019288:Herpesvirus 8, Human; D006689:Hodgkin Disease / Q000453:epidemiology / Q000209:etiology / Q000235:genetics / Q000276:immunology; D006801:Humans; D007111:Immunity, Cellular; D015994:Incidence; D016483:Lymphoma, AIDS-Related / Q000145:classification / Q000453:epidemiology / Q000209:etiology / Q000235:genetics / Q000276:immunology; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology / Q000209:etiology / Q000235:genetics / Q000276:immunology; D009154:Mutation; D015513:Oncogene Proteins; D009857:Oncogenes; D012514:Sarcoma, Kaposi / Q000453:epidemiology / Q000209:etiology / Q000235:genetics / Q000276:immunology; D014944:World Health Organization
D015513:Oncogene Proteins