Hivassociated Hodgkins Lymphoma

As with other AIDS-related malignancies, oncogenic viruses are thought to play a central role in the patho-genesis of HD. Single-cell PCR amplification methods can identify EBV in the Reed-Sternberg cells in approximately 10-70% HD, and in patients with HIV-associ-ated HD, EBV is found in the Reed-Sternberg cells in nearly all cases.94 There are also differences in the histopathology of HD between the immunocompetent population and the people with HIV. Two histopatho-logical subtypes occur at a higher frequency in people with HIV: these are mixed cellularity (approximately 40%) and lymphocyte depleted (approximately 20%).95'96 In the HIV-negative population, these subtypes occur at 24% and 3-6%, respectively, and are associated with a worse prognosis compared to the more common nodular sclerosing and lymphocyte-predominant subtypes. Mixed cellularity subtype is more common in developing countries and in the elderly,96 97 and immune dysfunction and epidemiol-gic differences of EBV are thought to be responsible for this; however, their prognosis is still better than the HIV-seropositive population.

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