The incidence and role of EBV and HIV in head and neck lymphomas : an institutional study

Abstract

OBJECTIVES : To determine the prevalence of Epstein-Barr virus (EBV) positive lymphomas in a cohort of patients with head and neck lymphomas and to correlate these lymphomas with HIV status, CD4+ cell count, clinical stage, and overall survival. STUDY DESIGN : This retrospective descriptive study sourced data from pathology reports and clinical records. Data collected included lymphoma type, HIV status, and medical information related to immunosuppression, CD4+ T-cell counts, HIV viral load, Ann Arbor clinical stage, and follow-up data. RESULTS : We reviewed 228 lymphomas, comprising 9 Hodgkin lymphomas and 219 non-Hodgkin lymphomas (HIV-positive: 133; HIV-negative: 23, and unknown HIV status: 72). Diffuse large B-cell lymphoma and plasmablastic lymphoma (PBL) were common and associated with HIV immune suppression, male sex, and middle age. Seventy-four lymphomas were Epstein-Barr encoded RNA in situ hybridization (EBER-ISH) positive. PBL was the most common EBV-driven lymphoma (median CD4+ count = 147 cells/mm3), with the highest Ann Arbor staging. CONCLUSION : These findings suggest that EBV infection is among the primary factors contributing to PBL oncogenesis in HIV-positive patients. Patients with PBL presented with CD4+ T-cell counts of <400 cells/mm3. Patients with HIV infection had a lower overall survival rate compared to HIV-negative patients, irrespective of lymphoma type. STATEMENT OF CLINICAL RELEVANCE : This study highlights the significant correlation between HIV infection and EBV-positive lymphomas in the head and neck regions, underscoring the need for vigilant screening and management strategies for lymphoma in HIV-positive patients to improve clinical outcomes.