Updated 20 June 2007
The lymphomas which arise in association with the human immunodeficiency virus are usually of large cell or Burkitt or Burkitt-like histologic subtype or, less often Hodgkin lymphoma. In general treatment should be the same as for non-AIDS related lymphoma if the patient's performance status is not otherwise compromised by the AIDS and he or she is free of coincident serious opportunistic infection. Rapid, effective control of the HIV and vigorous supportive care are essential to maximize the likelihood of cure of the lymphoma.
Treatment of HIV associated lymphoma should include (1) initiation of highly active anti-retroviral therapy (HAART) before or coincident with the planned chemotherapy; (2) lymphoma specific chemotherapy with or without rituximab and with or without radiation as determined by stage, histology and presence of CD20; (3) supportive care including anti-fungal, anti-Herpes virus and anti-Pneumocytis antibiotics and granulocyte stimulating growth factors as needed. To prevent rapid emergence of lamivudine-resistant HIV, patients with prior hepatitis B infection should not initiate lamivudine prophylaxis until HAART has also been started.