[Hodgkin's disease in patients infected with the human immunodeficiency virus]

Interventions for treating AIDS-associated Hodgkin s lymphoma in treatment-naive adults

BACKGROUND

Hodgkin's disease (HD) is the most common non-AIDS-defining malignancy in HIV-infected patients. Its unusually aggressive tumour behaviour includes a higher frequency of unfavourable histologic subtypes, high-stage and extranodal involvement by the time of presentation (anal canal, stomach), and poor therapeutic outcome, in comparison with HD outside the HIV setting. The optimal therapeutic strategy is still controversial, and median overall survival is short, ranging from 12 to 18 months. Thus, there is a need to identify the efficacy and safety of different interventions for AIDS-associated HD on overall survival and disease-free survival in treatment-naive adults with AIDS.

OBJECTIVES

To assess the effects of different interventions for treating AIDS-associated Hodgkin's disease including chemotherapy, bone marrow transplantation (BMT), and gene therapy on overall survival and disease-free survival in treatment-naive adults with AIDS.

SEARCH STRATEGY

We searched The Cochrane HIV/AIDS Group Trials Register (September 2006), which comprises references identified from comprehensive electronic database searches and handsearching of relevant journals and abstract books of conference proceedings. We also searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (Issue 3, 2006), MEDLINE (1966 to September 2006), EMBASE (1974 to September 2006) LILACS (1982 to September 2006), ISI Web of Knowledge (1993 to September 2006), and AIDSearch (1980 to December 2006). Date of most recent search: December 2006.

SELECTION CRITERIA

We searched for published or unpublished randomised controlled trials.

DATA COLLECTION AND ANALYSIS

We intended to summarise data by standard Cochrane Collaboration methodologies, but no eligible randomised controlled trials were identified.

MAIN RESULTS

We were unable to find any randomised controlled trials of interventions for treating AIDS-associated HD in treatment-naive adults with AIDS.

AUTHORS' CONCLUSIONS

Randomised controlled trials are needed to establish the efficacy and safety of interventions for treating AIDS-associated HD in treatment-naive adults with AIDS.

Advanced Hodgkin's disease in a pregnant HIV seropositive woman: favorable mother and baby outcome following combined anticancer and antiretroviral therapy

We describe a 33 y/o HIV(+) woman who developed advanced Hodgkin's disease (HD) during the 2nd trimester of her pregnancy. Combination chemotherapy and antiretroviral treatment along with opportunistic infection prophylaxis were administered. At term, while in partial remission, she delivered by a Caesarian section a healthy baby, PCR-negative for HIV. A complete remission was later achieved upon completion of the chemotherapy regimen. Since both the incidence of HD and the proportion of young women among the HIV(+) individuals are increasing, it seems important to recognize that successful completion of pregnancy with no deterioration of accepted surrogate parameters of HIV disease progression is achievable in a carefully treated HIV(+) pregnant woman with advanced HD.