HIV-MEDIATED B-LYMPHOCYTE ACTIVATION AND LYMPHOMAGENESIS

Non-Hodgkin's (1ii)lymphoma is an AIDS-defining event in a significant percent of U.S. patients infected with the human immunodeficiency vir us (HIV). Advances in anti-retroviral treatment and management of oppo rtunistic infection have been accompanied by an increase in the incide nce of these lymphomas. In the immunocompromised state of patients lat e in the course of HIV infection, these lymphomas represent a complica tion of HIV infection that is associated with an extremely poor progno sis. Currently, there is little understanding of the pathogenesis of H IV-associated lymphomas, which are nearly exclusively of B-cell origin . Experimental data do not support HIV infection in these lymphomas. W hile some lymphomas show evidence of EBV infection, the majority do no t. Polyclonal B-cell hyperactivity during the early phases of HIV infe ction argues that chronic B-cell stimulation may be the major process predisposing B-cells in the HIV-infected individual to malignant trans formation. The mechanism of this stimulation of normal B cells and its relationship to AIDS-associated lymphomas remain poorly understood. I n this review, we will summarize current information on HIV-associated B lymphoma and then discuss our views on the association and regulati on of HIV-related hyperactivity on the pathogenesis of this lymphoma.