AIDS-related cancer in the era of highly active antiretroviral therapy (HAART): a model of the interplay of the immune system, virus, and cancer. "On the offensive--the Trojan Horse is being destroyed"--Part B: Malignant lymphoma.
ABSTRACT The impact of highly active antiretroviral therapy (HAART) on the incidence of non-Hodgkin's lymphoma was less obvious initially, although primary central nervous system lymphoma (PCNSL) has dropped precipitously since the introduction of HAART. The pathogenesis of acquired immunodeficiency syndrome-related lymphoma is multifactorial. Epstein-Barr virus plays a significant role in these diseases, especially Burkitt lymphoma and PCNSL. Data regarding the effect of HAART on the natural history and treatment outcomes of these malignancies are emerging. The possibility of direct and indirect roles of human immunodeficiency virus in the carcinogenesis suggests that antiretroviral therapy may be an important component of the treatment for these malignancies. The simultaneous administration of HAART and chemotherapy does not appear to significantly alter the toxicity profile, although the information with respect to the interaction of HAART and chemotherapy is limited. The use of biological agents, for example, monoclonal antibody against CD-20, is being explored to improve the clinical outcome of this disease.
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ABSTRACT: Kaposi's sarcoma-associated herpesvirus (KSHV) or human herpesvirus-8 (HHV-8) is a newly identified herpesvirus. KSHV is an important pathogen capable of causing disease that affects all age groups worldwide. KSHV is etiologically associated with all forms of Kaposi's sarcoma (KS), body cavity lymphomas, and multicentric Castleman disease (MCD). The use of highly active antiretroviral therapy (HAART) since 1996 has markedly reduced the prevalence of KS in western countries, but because 99% of the 40 million patients with AIDS in the world cannot afford HAART, KSHV pathogenesis is still a very common problem. In this chapter, we delineate some of the latest findings about KSHV infection and pathogenesis.Frontiers in Bioscience 02/2005; 10:2882-91. · 3.52 Impact Factor