AIDS-related lymphomas in Nigeria

Aggressive non-Hodgkin's lymphoma (NHL), including primary central nervous system (CNS) lymphoma, lymphoblastic lymphoma and non-endemic Burkitt's lymphoma have been recognized as AIDS-defining cancers in most developed countries. However, HIV/AIDS epidemics appear not to have been associated with higher incidence of lymphomas in Africa. We therefore carried out this study to highlight the significance or otherwise of HIV/AIDS epidemics in the pathogenesis of lymphomas in a population of Nigerians with the disease. Since January 1993 to the present, all patients with haematologic cancers are routinely screened (following appropriate counseling) for HIV infection. Patients with a histological diagnosis of malignant chronic lymphoproliferative diseases {non-Hodgkin lymphoma (NHL), chronic lymphocytic leukaemia (CLL), Burkitt's lymphoma (BL) and Hodgkin lymphoma (HL)} at the Obafemi Awolowo University Teaching Hospitals' Complex, Ile-Ife from January 1993 to August 2008 were noted. Those patients confirmed to be HIV/AIDS positive among the cohort with lymphomas were retrospectively studied using their clinical case notes. Data obtained were analyzed using appropriate descriptive and inferential statistics. A total of 391 patients were histologically confirmed to have lymphoma {NHL-109, (27.9 percent); CLL-76, (19.4 percent); BL-178, (45.5 percent) and HL-28, (7.2 percent)} during the study period. Nine patients (2.3 percent) were confirmed to be HIV- positive, all within the age bracket 24-60 (median = 50) years. Six of these, five males and one female, ages 24-60 (median = 37.5) years, had NHL while another three, all females (age 50 - 68years; median = 56 years) had CLL. None of the patients with HL and BL were HIV positive. Patients with NHL presented at advanced stage of the disease (at least clinical stage IIIb), and all those with CLL presented at stage C of the International Working Party Classification. All the HIV-positive patients ...

Relation between erythrocyte sedimentation rate, clinical and immune status in HIV-infected patients.

BACKGROUND: The objective of this study was to determine the clinical and immunologic implications of an elevated ESR in HIV-infected patients. METHOD: One hundred and four consecutive HAART naïve human immunodeficiency virus (HIV)-infected adult patients and fifty one controls were studied. Detailed history was taken and full physical examination was conducted. Erythrocyte sedimentation rate (ESR), CD4+ T lymphocyte count, and complete blood count were performed. RESULTS: The mean (+/- SD) of ESR in the patients was 84.5 +/- 36.8 mm/1st one hour and that for the controls was 20.4 +/- 17.6 mm/1st one hour. The patients' ESR was significantly higher than those of the controls (p < 0.0001). There was a significant difference between the mean ESR of symptomatic (87.6 +/- 37.0 mm/1st hr) and asymptomatic patients (61.0 +/- 26.1 mm/1st hr) (p = 0.018), and between asymptomatic patients (mean +/- SD = 61 +/- 26.1 mm/1st one hour) and controls (mean +/- SD = 20.4 +/- 17.6 mm/1st one hour) (p = 0.000).The mean (+/- SD) CD4+ lymphocytes count of the patients and controls were 155.4 +/- 90.6 cells/microL, and 655.7 +/- 17.6 cells/microL, respectively. The CD4+ cells count was significantly lower in the patients than in the controls (p < 0.0001). CONCLUSION: ESR may be useful in monitoring HIV/AIDS disease.

AIDS-related lymphomas in Nigeria.

Aggressive non-Hodgkin's lymphoma (NHL), including primary central nervous system (CNS) lymphoma, lymphoblastic lymphoma and non-endemic Burkitt's lymphoma have been recognized as AIDS-defining cancers in most developed countries. However, HIV/AIDS epidemics appear not to have been associated with higher incidence of lymphomas in Africa. We therefore carried out this study to highlight the significance or otherwise of HIV/AIDS epidemics in the pathogenesis of lymphomas in a population of Nigerians with the disease. Since January 1993 to the present, all patients with haematologic cancers are routinely screened (following appropriate counseling) for HIV infection. Patients with a histological diagnosis of malignant chronic lymphoproliferative diseases {non-Hodgkin lymphoma (NHL), chronic lymphocytic leukaemia (CLL), Burkitt's lymphoma (BL) and Hodgkin lymphoma (HL)} at the Obafemi Awolowo University Teaching Hospitals' Complex, Ile-Ife from January 1993 to August 2008 were noted. Those patients confirmed to be HIV/AIDS positive among the cohort with lymphomas were retrospectively studied using their clinical case notes. Data obtained were analyzed using appropriate descriptive and inferential statistics. A total of 391 patients were histologically confirmed to have lymphoma {NHL-109, (27.9%); CLL-76, (19.4%); BL-178, (45.5%) and HL-28, (7.2%)} during the study period. Nine patients (2.3%) were confirmed to be HIV- positive, all within the age bracket 24-60 (median = 50) years. Six of these, five males and one female, ages 24-60 (median = 37.5) years, had NHL while another three, all females (age 50 - 68 years; median = 56 years) had CLL. None of the patients with HL and BL were HIV positive. Patients with NHL presented at advanced stage of the disease (at least clinical stage IIIb), and all those with CLL presented at stage C of the International Working Party Classification. All the HIV-positive patients with NHL succumbed to the disease within one to three weeks of admission into the hospital. The prevalence of AIDS-related lymphomas is 2.3% compared to 4.4% found in the general population. However, it is interesting that no single case of AIDS-associated BL was seen, despite the fact that Burkitt's lymphoma is endemic in this part of the world. All the patients presented at a very advanced stage of the disease with significantly shortened survival.

Relation between erythrocyte sedimentation rate, clinical and immune status in HIV-infected patients.

BACKGROUND: The objective of this study was to determine the clinical and immunologic implications of an elevated ESR in HIV-infected patients. METHOD: One hundred and four consecutive HAART naïve human immunodeficiency virus (HIV)-infected adult patients and fifty one controls were studied. Detailed history was taken and full physical examination was conducted. Erythrocyte sedimentation rate (ESR), CD4+ T lymphocyte count, and complete blood count were performed. RESULTS: The mean (+/- SD) of ESR in the patients was 84.5 +/- 36.8 mm/1st one hour and that for the controls was 20.4 +/- 17.6 mm/1st one hour. The patients' ESR was significantly higher than those of the controls (p < 0.0001). There was a significant difference between the mean ESR of symptomatic (87.6 +/- 37.0 mm/1st hr) and asymptomatic patients (61.0 +/- 26.1 mm/1st hr) (p = 0.018), and between asymptomatic patients (mean +/- SD = 61 +/- 26.1 mm/1st one hour) and controls (mean +/- SD= 20.4 +/- 17.6 mm/1st one hour) (p = 0.000).The mean (+/- SD) CD4+ lymphocytes count of the patients and controls were 155.4 +/- 90.6 cells/microL, and 655.7 +/- 17.6 cells/microL, respectively. The CD4+ cells count was significantly lower in the patients than in the controls (p < 0.0001). CONCLUSION: ESR may be useful in monitoring HIV/AIDS disease.