Case report of human immunodeficiency virus infection, Hodgkin lymphoma, and pregnancy.

ABSTRACT

As the incidence of human immunodeficiency virus (HIV) infection in women of child bearing age continues to increase in the era of highly active antiretroviral therapy and Hodgkin lymphoma (HL) is the most common non-acquired immunodeficiency syndrome defining malignancy, we anticipate that the number of cases of HIV-associated HL in pregnant women will increase in the near future. Herein, we describe the case of a pregnant 30-year-old HIV-infected Ethiopian woman with a CD4 count of 254 cells/microL and an HIV viral load of 1200 copies/mL who presented to medical attention with progressive neck adenopathy. Subsequent histopathology and radiographic findings revealed clinical stage IIIA Classical HL. After a spontaneous miscarriage of 10 weeks into her pregnancy, the patient began highly active antiretroviral therapy and chemotherapy. Thirty months later, she remained in complete remission. Through a literature review, we identified 2 additional case reports involving HIV, HL and pregnancy. One patient received 3 cycles of chemotherapy, refused further treatment, delivered an HIV-seropositive girl, and died shortly after from complications of presumed pneumocystis jiroveci pneumonia. The second patient received both active antiretroviral therapy and chemotherapy, delivered an HIV-seronegative boy, and remained in complete remission at 9 months follow-up. We conclude by offering recommendations for the staging and treatment of pregnant, HIV-infected patients with HL.