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Persons with the human immunodeficiency virus (HIV) have a much higher incidence of Non-Hodgkin’s Lymphoma (NHL) compared to persons without the virus. Results from a new study indicate that the majority of HIV related NHL may develop due to infection with the Epstein-Barr virus (EBV).

Non-Hodgkin’s lymphoma is a cancer of the lymph tissue, which is part of the body’s immune system. Lymph tissue is present in lymph nodes, lymph vessels and bone marrow, which exist throughout the body. It is also present in organs such as the thymus, tonsils and spleen. The main cells in the lymph system are lymphocytes, of which there are two types: B and T-cells. Each of these cells has a very specific function in aiding the body to fight infection. The large majority of NHL cases involve cancer of the B-lymphocytes, characterized by the excessive accumulation of these atypical cells. These cancerous cells can crowd the lymph tissue causing suppression of normal formation and function of other cells necessary for normal immune functions. Because lymphocytes can travel virtually anywhere in the body through blood or lymph fluid, lymphomas can occur in sites other than lymph tissue, such as the gastrointestinal tract or the brain. Patients with HIV related NHL often have fast growing, or high-grade lymphomas that tend to develop outside of the lymph system.

It is now known that some viruses have a direct association to the development of certain types of cancer. Recently, researchers from Denmark have reported a dramatic association between HIV related NHL to EBV. Epstein-Barr virus causes infectious mononucleosis in young adults and is also associated with Burkett’s lymphoma and some cases of Hodgkin’s disease. Because HIV infected persons have a weakened immune system, they are more susceptible to the infection of viruses such as EBV. In a recent analysis of 85 patients with HIV related lymphomas, EBV was detected in 79% of cases. From these statistics, the doctors concluded that EBV played a major role in causing lymphomas in these HIV infected patients.

This observation is important since treatment strategies are being developed which can target and kill EBV as well as lymphoma. Efforts are currently underway to develop a vaccine against EBV that could prevent EBV infections, and could potentially eliminate lymphomas caused by the virus. Persons with HIV related lymphoma may wish to talk to their physician about the risks and benefits of participating in a clinical trial utilizing new strategies against this cancer. Two sources of information on ongoing clinical trials that can be discussed with a doctor include comprehensive, easy to use clinical trials listing services provided by the National Institutes of Health (

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European Journal of Haematology, Vol 64, No 6, pp 368-375, 2000)

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