HIV infection predisposes to the development of non-Hodgkin lymphoma (
NHL). The frequency of NHL among HIV-positive adults and children in s
ub-Saharan Africa is not known. In 1991-1992, a representative autopsy
study of HIV infection was performed in Abidjan, Cote d'Ivoire. Of 24
7 HIV-positive adult (> 14 years) medical patients dying in hospital,
2.8% had NHL, 1.6% with visceral NHL and 1.2% with primary cerebral ly
mphoma. The estimated crude incidence of NHL among HIV-positive adults
in Abidjan was 84/100,000 per year, 10-fold greater than the expected
pre-AIDS incidence of NHL but less than the incidence observed among
HIV-positive adults in industrialised countries. None of 78 autopsied
HIV-positive children (median age = 17 months) had NHL. HIV infection
augments the incidence of NHL among adults in Africa, but short surviv
al with advanced HIV disease probably prevents the major increase in H
IV-associated NHL seen in industrialised countries. Survival of HIV-po
sitive children in Africa appears too short to permit the significant
development of additional NHL; classic Burkitt lymphoma is not an AIDS
-associated tumour in Africa. (C) 1994 Wiley-Liss, Inc.