The incidence and role of EBV and HIV in head and neck lymphomas: an institutional study.

OBJECTIVES

To determine the prevalence of Epstein-Barr virus (EBV) positive lymphomas in a cohort of patients with head and neck lymphomas and to correlate these lymphomas with HIV status, CD4+ cell count, clinical stage, and overall survival.

STUDY

DESIGN

This retrospective descriptive study sourced data from pathology reports and clinical records. Data collected included lymphoma type, HIV status, and medical information related to immunosuppression, CD4+ T-cell counts, HIV viral load, Ann Arbor clinical stage, and follow-up data.

RESULTS

We reviewed 228 lymphomas, comprising 9 Hodgkin lymphomas and 219 non-Hodgkin lymphomas (HIV-positive: 133; HIV-negative: 23, and unknown HIV status: 72). Diffuse large B-cell lymphoma and plasmablastic lymphoma (PBL) were common and associated with HIV immune suppression, male sex, and middle age. Seventy-four lymphomas were Epstein-Barr encoded RNA in situ hybridization (EBER-ISH) positive. PBL was the most common EBV-driven lymphoma (median CD4+ count = 147 cells/mm3), with the highest Ann Arbor staging.

CONCLUSION

These findings suggest that EBV infection is among the primary factors contributing to PBL oncogenesis in HIV-positive patients. Patients with PBL presented with CD4+ T-cell counts of <400 cells/mm3. Patients with HIV infection had a lower overall survival rate compared to HIV-negative patients, irrespective of lymphoma type.