HIV in Children

HIV AND MALIGNANCY

Dr. Ira Shah
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Last Updated :1 st September 2012
HIV-infected children have an increased incidence of malignancy compared to HIV-uninfected children. This is likely to be due to a combination of immunosuppression (highlighting the importance of a functional immune system in tumor surveillance) and co-infection with oncogenic viruses. The three commonest malignancies of HIV-infected children are non-Hodgkin’s lymphoma (NHL), smooth muscle tumors and Kaposi’s sarcoma (KS). NHL and smooth muscle tumors are associated with infection with Epstein Barr virus (EBV) whereas KS is associated with infection with Human Herpes Virus – 8 (HHV-8). KS in uncommon in HIV-infected children in Europe / USA and India, it is the commonest pediatric HIV-associated malignancy in sub-Saharan Africa.

HIV associated lymphomas include: (1) high-grade B-cell lymphomas: Burkitt lymphoma, diffuse large B-cell lymphoma with centroblastic features and with immunoblastic features; (2) unusual lymphomas, 'primary effusion lymphoma' (PEL) and 'plasmablastic lymphoma' of the oral cavity.

References


  1. Saple DG, Shah Ira, Surjushe AU, Murthy A, Chudgar P, Gote PD. Lymphoma in HIV patients: Varied Presentations. Indian J Med Paediatr Oncol. 2010; 31: 39-42
  2. Prendergast A, Klein N. The Immunology and Malignancy of Paediatric HIV. Available from Tr@inforPedHIV 2011.
  3. Besson C, Goubar A, Gabarre J et al. Changes in AIDS-related lymphoma since the era of highly active antiretroviral therapy. Blood 2001; 98:2339–2344.
  4. Gerard L, Agbalika F, Sheldon J, Maillard A, Schulz TF, Oksenhendler E. No increased human herpes virus 8 seroprevalence in patients with HIV-associated non-Hodgkin's lymphoma. J Acquir Immune Defic Syndr. 2001; 26: 182-184.
HIV AND MALIGNANCY
Dr. Ira Shah
Incharge Pediatric HIV and TB Clinic, B.J.Wadia Hospital for Children, Mumbai, India Consultant in Pediatric Infectious Diseases, Nanavati Hospital, Mumbai, India.