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BMC Cancer
Published in: BMC Cancer 1/2018

Open Access 01-12-2018 | Case report

Case report: dual primary AIDS-defining cancers in an HIV-infected patient receiving antiretroviral therapy: Burkitt’s lymphoma and Kaposi’s sarcoma

Authors: Seong Eun Kim, Younggon Jung, Tae Hoon Oh, Uh Jin Kim, Seung-Ji Kang, Hee-Chang Jang, Kyung-Hwa Park, Kyung-Hwa Lee, Sook In Jung

Published in: BMC Cancer | Issue 1/2018

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Abstract

Background

The incidence of AIDS-defining cancers (ADCs) has decreased markedly in the era of highly active antiretroviral therapy (HAART). The occurrence of two ADCs is rare in people living with HIV or AIDS (PWHA) who are severely immunosuppressed or have incomplete virologic suppression.

Case presentation

We report a case of dual primary ADCs, especially NHL followed by KS, in a 70-year-old HIV-infected man who was on antiretroviral therapy and had successful virologic suppression. During HAART, he presented with generalized myalgia and abdominal pain. Multiple liver masses were detected and a biopsy revealed Burkitt’s lymphoma. After three cycles of anticancer chemotherapy with a favorable response, he was diagnosed with cytomegalovirus retinitis and the anti-cancer chemotherapy was discontinued. Despite successful virologic suppression with HAART, human herpes virus-8 associated Kaposi’s sarcoma was diagnosed in his right thigh. He underwent radiation therapy.

Conclusion

These findings suggest that multiple ADCs can occur in PWHA who are receiving HAART and have successful virologic suppression. Healthcare providers caring for PWHA should maintain vigilance for the development of a broad spectrum of cancers.
Literature
1.
Shiels MS, Engels EA. Evolving epidemiology of HIV-associated malignancies. Curr Opin HIV AIDS. 2017;12:6–11.CrossRef
2.
Centers for Disease Control and Prevention. HIV surveillance - United States, 1981-2008. MMWR Morb Mortal Wkly Rep. 2011;60:689–93.
3.
Mortality GBD, Causes of Death C. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the global burden of disease study 2015. Lancet. 2016;388:1459–544.CrossRef
4.
Grulich AE. Cancer: the effects of HIV and antiretroviral therapy, and implications for early antiretroviral therapy initiation. Curr Opin HIV AIDS. 2009;4:183–7.CrossRef
5.
Lee S, Lee SH, Lee JE, Kang JS, Lee SG, Chung JS, Kwak IS. Trends in malignancies among Korean patients infected with human immunodeficiency virus in the highly active antiretroviral therapy era. J Korean Med Sci. 2017;32:1445–50.CrossRef
6.
Grulich AE, van Leeuwen MT, Falster MO, Vajdic CM. Incidence of cancers in people with HIV/AIDS compared with immunosuppressed transplant recipients: a meta-analysis. Lancet. 2007;370:59–67.CrossRef
7.
Deeken JF, Tjen ALA, Rudek MA, Okuliar C, Young M, Little RF, Dezube BJ. The rising challenge of non-AIDS-defining cancers in HIV-infected patients. Clin Infect Dis. 2012;55:1228–35.CrossRef
8.
Ledergerber B, Telenti A, Egger M. Risk of HIV related Kaposi's sarcoma and non-Hodgkin's lymphoma with potent antiretroviral therapy: prospective cohort study. Swiss HIV cohort study. BMJ. 1999;319:23–4.CrossRef
9.
Centers for Disease Control and Prevention. Revised classification system for HIV infection and expanded case definitions for AIDS among adolescents and adults. MMWR. 1993;41(RR-17):1992.
10.
Chen M, Jen I, Chen YH, Lin MW, Bhatia K, Sharp GB, Law MG, Arthur Chen YM. Cancer incidence in a Nationwide HIV/AIDS patient cohort in Taiwan in 1998-2009. J Acquir Immune Defic Syndr. 2014;65:463–72.CrossRef
11.
Polesel J, Franceschi S, Suligoi B, Crocetti E, Falcini F, Guzzinati S, Vercelli M, Zanetti R, Tagliabue G, Russo A, Luminari S, Stracci F, De Lisi V, Ferretti S, Mangone L, Budroni M, Limina RM, Piffer S, Serraino D, Bellù F, Giacomin A, Donato A, Madeddu A, Vitarelli S, Fusco M, Tessandori R, Tumino R, Piselli P, Dal Maso L; Cancer and AIDS Registries Linkage Study Cancer; AIDS Registries Linkage Study, Lise M, Zucchetto A, De Paoli A, Intrieri T, Vattiato R, Zambon P, Puppo A, Patriarca S, Tittarelli A, Autelitano M, Cirilli C, La Rosa F, Sgargi P, Di Felice E, Cesaraccio R, Donato F, Franchini S, Zanier L, Vittadello F, Vercellino PC, Senatore G, Contrino ML, Antonini S, Palombino R, Maspero S, La Rosa MG, Camoni L, Regine V. Cancer incidence in people with AIDS in Italy. Int J Cancer 2010;127:1437–1445.
12.
Robbins HA, Shiels MS, Pfeiffer RM, Engels EA. Epidemiologic contributions to recent cancer trends among HIV-infected people in the United States. AIDS. 2014;28:881–90.CrossRef
13.
Franceschi S, Lise M, Clifford GM, Rickenbach M, Levi F, Maspoli M, Bouchardy C, Dehler S, Jundt G, Ess S, Bordoni A, Konzelmann I, Frick H, Dal Maso L, Elzi L, Furrer H, Calmy A, Cavassini M, Ledergerber B, Keiser O, Swiss HIV cohort study. Changing patterns of cancer incidence in the early- and late-HAART periods: the Swiss HIV cohort study. Br J Cancer. 2010;103:416–22.CrossRef
14.
Antiretroviral Therapy Cohort Collaboration (ART-CC), Mocroft A, Sterne JA, Egger M, May M, Grabar S, Furrer H, Sabin C, Fatkenheuer G, Justice A, Reiss P, d'Arminio Monforte A, Gill J, Hogg R, Bonnet F, Kitahata M, Staszewski S, Casabona J, Harris R, Saag M. Variable impact on mortality of AIDS-defining events diagnosed during combination antiretroviral therapy: not all AIDS-defining conditions are created equal. Clin Infect Dis. 2009;48:1138–51.CrossRef
15.
Dubrow R, Silverberg MJ, Park LS, Crothers K, Justice AC. HIV infection, aging, and immune function: implications for cancer risk and prevention. Curr Opin Oncol. 2012;24:506–16.CrossRef
16.
Wang B, Song B, Oster C, Cao J, Raza A, Wang J. Coexistence of intestinal Kaposi sarcoma and plasmablastic lymphoma in an HIV/AIDS patient: case report and review of the literature. J Gastrointest Oncol. 2016;7:S88–95.PubMedPubMedCentral
17.
Manfredi R, Calza L, Chiodo F. Multiple AIDS-related malignancies just in the era of potent antiretroviral therapy. A rare but intriguing finding. Infez Med. 2003;11:153–6.PubMed
18.
Ascoli V, Mastroianni CM, Galati V, Sirianni MC, Fruscalzo A, Pistilli A, Lo Coco F. Primary effusion lymphoma containing human herpesvirus 8 DNA in two AIDS patients with Kaposi's sarcoma. Haematologica. 1998;83:8–12.PubMed
19.
Hecht JL, Aster JC. Molecular biology of Burkitt's lymphoma. J Clin Oncol. 2000;18:3707–21.CrossRef
20.
Levine AM. Challenges in the management of Burkitt's lymphoma. Clin Lymphoma. 2002;3(Suppl 1):S19–25.CrossRef
21.
Kuo CP, Wu CL, Ho HT, Chen CG, Liu SI, Lu YT. Detection of cytomegalovirus reactivation in cancer patients receiving chemotherapy. Clin Microbiol Infect. 2008;14:221–7.CrossRef
22.
Chang Y, Cesarman E, Pessin MS, Lee F, Culpepper J, Knowles DM, Moore PS. Identification of herpesvirus-like DNA sequences in AIDS-associated Kaposi's sarcoma. Science. 1994;266:1865–9.CrossRef
23.
Katz MH, Hessol NA, Buchbinder SP, Hirozawa A, O'Malley P, Holmberg SD. Temporal trends of opportunistic infections and malignancies in homosexual men with AIDS. J Infect Dis. 1994;170:198–202.CrossRef
24.
La Ferla L, Pinzone MR, Nunnari G, Martellotta F, Lleshi A, Tirelli U, De Paoli P, Berretta M, Cacopardo B. Kaposi' s sarcoma in HIV-positive patients: the state of art in the HAART-era. Eur Rev Med Pharmacol Sci. 2013;17:2354–65.PubMed
25.
Brander C, Suscovich T, Lee Y, Nguyen PT, O'Connor P, Seebach J, Jones NG, van Gorder M, Walker BD, Scadden DT. Impaired CTL recognition of cells latently infected with Kaposi's sarcoma-associated herpes virus. J Immunol. 2000;165:2077–83.CrossRef
26.
Wilkinson J, Cope A, Gill J, Bourboulia D, Hayes P, Imami N, Kubo T, Marcelin A, Calvez V, Weiss R, Gazzard B, Boshoff C, Gotch F. Identification of Kaposi's sarcoma-associated herpesvirus (KSHV)-specific cytotoxic T-lymphocyte epitopes and evaluation of reconstitution of KSHV-specific responses in human immunodeficiency virus type 1-infected patients receiving highly active antiretroviral therapy. J Virol. 2002;76:2634–40.CrossRef
27.
Ensoli B, Barillari G, Salahuddin SZ, Gallo RC, Wong-Staal F. Tat protein of HIV-1 stimulates growth of cells derived from Kaposi's sarcoma lesions of AIDS patients. Nature. 1990;345:84–6.CrossRef
28.
Ensoli B, Gendelman R, Markham P, Fiorelli V, Colombini S, Raffeld M, Cafaro A, Chang HK, Brady JN, Gallo RC. Synergy between basic fibroblast growth factor and HIV-1 tat protein in induction of Kaposi's sarcoma. Nature. 1994;371:674–80.CrossRef
29.
Tovo PA. Highly active antiretroviral therapy inhibits cytokine production in HIV-uninfected subjects. AIDS. 2000;14:743–4.CrossRef
30.
Sgadari C, Barillari G, Toschi E, Carlei D, Bacigalupo I, Baccarini S, Palladino C, Leone P, Bugarini R, Malavasi L, Cafaro A, Falchi M, Valdembri D, Rezza G, Bussolino F, Monini P, Ensoli B. HIV protease inhibitors are potent anti-angiogenic molecules and promote regression of Kaposi sarcoma. Nat Med. 2002;8:225–32.CrossRef
31.
Lupia R, Wabuyia PB, Otiato P, Fang CT, Tsai FJ. Risk factors for Kaposi's sarcoma in human immunodeficiency virus patients after initiation of antiretroviral therapy: a nested case-control study in Kenya. J Microbiol Immunol Infect. 2017;50:781–8.CrossRef
32.
Kaufmann GR, Perrin L, Pantaleo G, Opravil M, Furrer H, Telenti A, Hirschel B, Ledergerber B, Vernazza P, Bernasconi E, Rickenbach M, Egger M, Battegay M, Swiss HIV Cohort Study Group. CD4 T-lymphocyte recovery in individuals with advanced HIV-1 infection receiving potent antiretroviral therapy for 4 years: the Swiss HIV cohort study. Arch Intern Med. 2003;163:2187–95.CrossRef
33.
Kaufmann GR, Furrer H, Ledergerber B, Perrin L, Opravil M, Vernazza P, Cavassini M, Bernasconi E, Rickenbach M, Hirschel B, Battegay M, Swiss HIV Cohort Study. Characteristics, determinants, and clinical relevance of CD4 T cell recovery to <500 cells/microL in HIV type 1-infected individuals receiving potent antiretroviral therapy. Clin Infect Dis. 2005;41:361–72.CrossRef
34.
35.
Aberg JA, Gallant JE, Ghanem KG, Emmanuel P, Zingman BS, Horberg MA, Infectious Diseases Society of America. Primary care guidelines for the management of persons infected with HIV: 2013 update by the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2014;58:1–10.CrossRef
36.
37.
Morrison BJ, Labo N, Miley WJ, Whitby D. Serodiagnosis for tumor viruses. Semin Oncol. 2015;42:191–206.CrossRef
38.
Van Baarle D, Wolthers KC, Hovenkamp E, Hovenkamp E, Niesters HG, Osterhaus AD, Miedema F, Van Oers MH. Absolute level of Epstein-Barr virus DNA in human immunodeficiency virus type 1 infection is not predictive of AIDS-related non-Hodgkin lymphoma. J Infect Dis. 2002;186:405–9.CrossRef
Metadata
Title
Case report: dual primary AIDS-defining cancers in an HIV-infected patient receiving antiretroviral therapy: Burkitt’s lymphoma and Kaposi’s sarcoma
Authors
Seong Eun Kim
Younggon Jung
Tae Hoon Oh
Uh Jin Kim
Seung-Ji Kang
Hee-Chang Jang
Kyung-Hwa Park
Kyung-Hwa Lee
Sook In Jung
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2018
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-018-5019-9

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