Hodgkin's disease

Hodgkin's disease is a type of lymphoma - a tumour of lymph nodes - named after Thomas Hodgkin, a pathologist who first described it in the early nineteenth century. It is caused by cells that normally live in lymph nodes, particularly lymphocytes, growing out of control and making the node swell. Depending on the type of lymphoma, these cells can spread to other parts of the body causing more damage. The other main kind of lymphoma is non-Hodgkin's lymphoma.

Recent research has confirmed that people with HIV are at increased risk of Hodgkin's disease, despite some early research to the contrary. A number of studies have found that the incidence of Hodgkin's lymphoma among people with AIDS is around eight times the rate in the general population. It is also more common in people who had low nadir CD4 cell counts.1 Despite these associations, Hodgkin's lymphoma is not recognised as an AIDS-defining illness. The majority of people with HIV who have developed Hodgkin's disease have had CD4 cell counts around 200 to 300 cells/mm3. It is now one of the most common non-AIDS-defining cancers in people with HIV (see also Cancer for further information on the incidence of non-AIDS defining cancers in people with HIV).

Hodgkin's disease tends to be a more aggressive cancer in HIV-infected people, with the 'mixed cellularity subtype' predominating, and a greater likelihood of being diagnosed at an advanced stage when the cancer has already spread beyond the lymph nodes to the bone marrow. Most cases of Hodgkin's disease which occur among HIV-infected people are linked to infection with Epstein-Barr virus.2 3 4

References

  1. Patel P et al. Incidence of non-AIDS-defining malignancies in the HIV outpatient study. Eleventh Conference on Retroviruses and Opportunistic Infections, San Francisco, abstract 81, 2004
  2. Dolcetti R et al. Pathogenetic and histogenetic features of HIV-associated Hodgkin's disease. Eur J Cancer 37: 1276-1287, 2001
  3. Rapezzi D et al. Histological subtypes of Hodgkin's disease in the setting of HIV infection. Annals of Hematology 80(6): 340-344, 2001
  4. Vaccher E et al. Clinical aspects and management of Hodgkin's disease and other tumours in HIV-infected individuals. European Journal of Cancer 37(10): 1306-1315, 2001