HIV-Related Lymphoproliferative Diseases in the Era of Combination Antiretroviral Therapy

HIV-positive patients have a 60- to 200-fold increased incidence of Non-HodgkinLymphomas (NHL) because of their impaired cellular immunity. Some NHL are consideredAcquired Immunodeficiency Syndrome (AIDS) defining conditions. Diffuse large B-cell Lymphoma(DLBC) and Burkitt Lymphoma (BL) are the most commonly observed, whereas Primary EffusionLymphoma (PEL), Central Nervous System Lymphomas (PCNSL), Plasmablastic Lymphoma (PBL)and classic Hodgkin Lymphoma (HL) are far less frequent. Multicentric Castleman disease (MCD)is an aggressive lymphoproliferative disorder highly prevalent in HIV-positive patients and stronglyassociated with HHV-8 virus infection. In the pre-Combination Antiretroviral Therapy (CART) era,patients with HIV-associated lymphoma had poor outcomes with median survival of 5 to 6 months.By improving the immunological status, CART extended the therapeutic options for HIV positivepatients with lymphomas, allowing them to tolerate standard chemotherapies regimen with similaroutcomes to those of the general population. The combination of CART and chemotherapy/immuno-chemotherapy treatment has resulted in a remarkable prolongation of survival among HIVinfectedpatients with lymphomas. In this short communication, we briefly review the problemslinked with the treatment of lymphoproliferative diseases in HIV patients. CombinationAntiretroviral Therapy (CART) not only reduces HIV replication and restores the immunologicalstatus improving immune function of the HIV-related lymphomas patients but allows patients todeal with standard doses of chemotherapies. The association of CART and chemotherapy allowedto obtain better results in terms of overall survival and complete responses. In the setting of HIVassociatedlymphomas, many issues remain open and their treatment is complicated by the patient’simmunocompromised status and the need to treat HIV concurrently.