Decrease in Epstein-Barr virus-positive AIDS-related lymphoma in the era of highly active antiretroviral therapy.
Recent introduction of highly active antiretroviral therapy (HAART) is reported to have reduced the incidence of lymphoma among HIV-infected individuals. A clinicopathological study was performed on 86 AIDS-related lymphoma patients who were treated in Tokyo area from 1987 to 2005. The incidence of lymphoma detected by autopsy was 27% (53 cases/198 autopsies). Diffuse large B cell lymphoma was the most predominant histological subtype throughout the period (78%). Burkitt's lymphoma (BL) increased from 2% in the pre-HAART era (before end-1997) to 13% in the HAART era, whereas incidence of BL did not vary between HAART users and non-users. Epstein-Barr virus (EBV)-positive lymphoma decreased from 88% in the pre-HAART era to 58% in the HAART era, but did not differ significantly between HAART users (73%) and non-users (74%). Nodal involvement of lymphoma increased from 14% in the pre-HAART era to 50% in the HAART era; however, central nervous system involvement decreased from 62 to 38%. Kaposi's sarcoma-associated herpesvirus infection was rare (4%) among all cases. These data suggest that HAART might play a partial role in these changes, and the alteration in immunological backgrounds, such as EBV prevalence, is suggested as another leading cause of these changes in Japanese AIDS-related lymphoma.
Hishima
Tsunekazu
T
Department of Pathology, Tokyo Metropolitan Komagome Hospital, Honkomagome 3-18-22, Bunkyo-ku, Tokyo 113-8677, Japan.
Oyaizu
Naoki
N
Fujii
Takeshi
T
Tachikawa
Natsuo
N
Ajisawa
Atsushi
A
Negishi
Masayoshi
M
Nakamura
Tetsuya
T
Iwamoto
Aikichi
A
Hayashi
Yukiko
Y
Matsubara
Daisuke
D
Sasao
Yuki
Y
Kimura
Satoshi
S
Kikuchi
Yoshimi
Y
Teruya
Katsuji
K
Yasuoka
Akira
A
Oka
Shinichi
S
Saito
Kiyoshi
K
Mori
Shigeo
S
Funata
Nobuaki
N
Sata
Tetsutaro
T
Katano
Harutaka
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D002051:Burkitt Lymphoma / Q000453:epidemiology; D002648:Child; D020031:Epstein-Barr Virus Infections / Q000453:epidemiology* / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D004854:Herpesvirus 4, Human; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D016483:Lymphoma, AIDS-Related / Q000453:epidemiology* / Q000821:virology; D016393:Lymphoma, B-Cell / Q000453:epidemiology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000453:epidemiology; D008297:Male; D008875:Middle Aged