BL in HIV

 Q: 34 years old male with a known history of HIV is admitted with life-threatening pneumonia. Patient is also diagnosed with Burkitt lymphoma (BL). Noncompliance to antiretroviral therapy (ART) should be suspected? 

A) True 

B) False 

Answer: B 

It is surprising that despite adherence to antiretroviral therapy (ART), the rate of BL doesn't go down in HIV patients. It is most prevalent in young HIV patients. Another paradox is its diagnosis in patients who have their CD4 count above 200 cells/microL. 

This is in contrast to primary CNS lymphoma and/or non-CNS diffuse large B cell lymphoma which shows a correlation with lower CD4 counts. 

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References:

1. Guech-Ongey M, Simard EP, Anderson WF, et al. AIDS-related Burkitt lymphoma in the United States: what do age and CD4 lymphocyte patterns tell us about etiology and/or biology? Blood 2010; 116:5600.

2. Ferry JA. Burkitt's lymphoma: clinicopathologic features and differential diagnosis. Oncologist 2006; 11:375. 

3. Gabarre J, Raphael M, Lepage E, et al. Human immunodeficiency virus-related lymphoma: relation between clinical features and histologic subtypes. Am J Med 2001; 111:704.