DIAGNOSIS AND MANAGEMENT LYMPHOMA IN HIV DISEASE OF SYSTEMIC NON-HODGKIN'S

In 1985, the CDC defined non-Hodgkin’s lymphoma (NHL) as one of the AIDS-defining malignancies.8 As the epidemic widens and the average life-span of HIV-infected individuals increases= owing to more effective antiretroviral agents and improved treatment of opportunistic infections, the incidence of lymphoma is expected to increase as well. The clinical characteristics of HIVassociated NHLs are complex. Diagnosis requires a high index of suspicion, because NHL may present in virtually any site across all stages of HIV infection. The clinical outcome from therapy largely depends on the stage of the underlying HIV disease. NHL in the HIV setting presents as either systemic lymphoma or primary central nervous system disease. The clinical characteristics, treatment, response, and survival for each of these presentations are quite different. This article reviews the diagnosis and management of systemic non-Hodgkin’s lymphoma in the HIV setting.