HIV‐associated lymphoma in Africa: An autopsy study in Ĉote D'ivoire

Abstract

HIV infection predisposes to the development of non‐Hodgkin lymphoma (NHL). The frequency of NHL among HIV‐positive adults and children in sub‐Saharan Africa is not known. In 1991–1992, a representative autopsy study of HIV infection was performed in Abidjan, Cǒte d'Ivoire. Of 247 HIV‐positive adult (> 14 years) medical patients dying in hospital, 2.8% had NHL, 1.6% with visceral NHL and 1.2% with primary cerebral lymphoma. The estimated crude incidence of NHL among HIV‐positive adults in Abidjan was 84/ 100,000 per year, 10‐fold greater than the expected pre‐AIDS incidence of NHL but less than the incidence observed among HIV‐positive adults in industrialised countries. None of 78 autopsied HIV‐positive children (median age = 17 months) had NHL. HIV infection augments the incidence of NHL among adults in Africa, but short survival with advanced HIV disease probably prevents the major increase in HIV‐associated NHL seen in industrialised countries. Survival of HIV‐positive children in Africa appears too short to permit the significant development of additional NHL; classic Burkitt lymphoma is not an AIDS‐associated tumour in Africa.