HIV, AIDS, and Non-Hodgkin’s Lymphoma
People with HIV (human immunodeficiency virus) have a weakened immune system. As a result, they are more likely to develop certain cancers. This includes non-Hodgkin's lymphoma (NHL). Also known as AIDS-related lymphoma, this is a cancer of white blood cells. White blood cells fight infection.
AIDS (acquired immunodeficiency syndrome) is a later stage of HIV infection. Fortunately, antiretroviral therapy has cut the rate of non-Hodgkin's lymphoma in HIV-positive people significantly.
HIV and Other Risk Factors for Non-Hodgkin's Lymphoma
In addition to HIV, these are risk factors associated with non-Hodgkin's lymphoma:
- Being older, male, or white
- Autoimmune diseases, such as rheumatoid arthritis
- Human T-lymphotrophic virus type 1 or Epstein-Barr virus
- A history of H-pylori infection
- Organ transplant
- Exposure to certain pesticides
- A diet high in meats and fat
- Past treatment for Hodgkin's lymphoma
How Non-Hodgkin's Lymphoma Develops in HIV
The longer you have a weakened immune system, the greater your chance of getting non-Hodgkin's lymphoma. But you can develop this cancer even if you have a high CD4 count. CD4 cells are a type of immune system cell.
Non-Hodgkin's lymphoma starts in the lymph system. This system is found throughout your body, so the cancer can show up almost anywhere. It can spread to the liver, bone, brain, abdomen, and other parts of your body. This can happen more quickly in someone with a weakened immune system.
Symptoms of Non-Hodgkin's Lymphoma
The symptoms of non-Hodgkin's lymphoma can be vague. You may easily confuse them with AIDS-related symptoms. These are common symptoms of NHL:
- Night sweats
- Weight loss
- Swelling in lymph nodes in your neck, underarm, groin, or stomach
- Skin rash or itchy skin
- Pain in your chest, abdomen, or bones
Diagnosing Non-Hodgkin's Lymphoma
Your doctor will complete a physical exam. Your doctor will also ask you about your history of health habits, past illnesses, and treatments. It's likely that your doctor will order tests like these:
- Blood tests, to check levels of different types of blood cells, enzymes, and other substances
- Lymph node biopsy, which involves removing part or all of a lymph node and examining it under a microscope
- Bone marrow biopsy, which involves removing bone marrow, blood, and a small piece of bone from your hipbone or breastbone and examining it under a microscope.
- Chest X-ray, which creates a picture of organs and bones inside your chest
A biopsy is needed to confirm a diagnosis of non-Hodgkin's lymphoma. After diagnosis, you will likely need imaging tests to find how far the cancer has spread.
If you're diagnosed with non-Hodgkin's lymphoma, you're at greater risk for an opportunistic infection called pneumocystis pneumonia. Your doctor may suggest that you take medications to prevent it.
Treating Non-Hodgkin's Lymphoma
HIV therapy can make a big difference in the outcome of your cancer. How successful your treatment is (called your prognosis) depends on several factors like these:
- How advanced the cancer is (the stage)
- The number of CD4 cells you have
- Whether or not you've had other AIDS-related opportunistic infections