Hodgkin's disease in patients infected by the human immunodeficiency virus. Study of fifteen cases

BACKGROUND: In spite of not being considered as an AIDS defining illnes, Ho dgkin's disease (HD) has specific clinical and biological features in HIV-i nfected patients. PATIENTS AND METHODS: Study of clinicopathologic and analytic characteristi cs, Epstein-Barr virus (EBV) detection (polymerase chain reaction), and pro gnosis in 15 patients with HD and HIV infection, RESULTS: Thirteen patients had 8 symptoms, 10 extranodal involvement and 12 advanced HD, The most frequent histologic subtypes were mixed cellularity (6) and lymphocyte depletion (6). The mean (SD) of CD4 lymphocytes was 0.10 (0.08) x 10(9)/l, The presence of EBV in lymph node biopsy was demonstrate d in 3 out of 4 patients investigated. Complete remission (CR) was achieved in 7 out of 14 treated cases (50%), the median overall survival was 26 mon ths and the 2 year event-free survival probability was 60%. CONCLUSSIONS: In HIV-infected patients, HD presents in advanced stages, unf avourable histologic subtypes, frequent extranodal involvement and B sympto ms. The prognosis is poor, mainly because of a low CR rate.