HIV-associated lymphoma in the era of combination antiretroviral therapy: shifting the immunological landscape

被引:23
作者
Carroll, Virginia [1 ,2 ]
Garzino-Demo, Alfredo [1 ,2 ,3 ]
机构
[1] Univ Maryland, Sch Med, Inst Human Virol, Baltimore, MD 21201 USA
[2] Univ Maryland, Sch Med, Dept Microbiol & Immunol, Baltimore, MD 21201 USA
[3] Univ Padua, Dept Mol Med, I-35121 Padua, Italy
关键词
HIV-1; virus; lymphomagenesis; antiretroviral drugs; immune activation; chronic infection; DEPENDENT CELLULAR CYTOTOXICITY; AIDS-DEFINING CANCERS; NATURAL-KILLER-CELLS; BARR-VIRUS INFECTION; HODGKIN-LYMPHOMA; BONE-MARROW; T-CELLS; VIRAL REPLICATION; PROGENITOR CELLS; NK CELLS;
D O I
10.1093/femspd/ftv044
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
HIV infection increases the risk of many types of cancer, including lymphoma. Combination antiretroviral therapy (cART) has reduced, but not eliminated, the risk of HIV-associated lymphoma. There has been a substantial shift in the subtypes of lymphoma observed in HIV-infected patients treated with cART. In this review, we will first outline these changes based on epidemiological studies and describe the impact of cART on lymphoma risk and mortality. Then, we will discuss some immunological factors that may contribute to the increased risk of lymphoma persisting after the administration of cART, including immunological non-response to therapy, chronic B-cell activation and dysfunction, T follicular helper cells, natural killer cells and altered lymphopoiesis. A better understanding of the pathophysiologic mechanisms of HIV-associated lymphoma under effective cART will inform future treatment strategies.
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页数:7
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