The incidence and role of EBV and HIV in head and neck lymphomas: an institutional study.

Objectives: To determine the prevalence of Epstein-Barr virus (EBV) positive lymphomas in a cohort of patients with head and neck lymphomas and to correlate these lymphomas with HIV status, CD4⁺ cell count, clinical stage, and overall survival.

Study design: This retrospective descriptive study sourced data from pathology reports and clinical records. Data collected included lymphoma type, HIV status, and medical information related to immunosuppression, CD4⁺ T-cell counts, HIV viral load, Ann Arbor clinical stage, and follow-up data.

Results: We reviewed 228 lymphomas, comprising 9 Hodgkin lymphomas and 219 non-Hodgkin lymphomas (HIV-positive: 133; HIV-negative: 23, and unknown HIV status: 72). Diffuse large B-cell lymphoma and plasmablastic lymphoma (PBL) were common and associated with HIV immune suppression, male sex, and middle age. Seventy-four lymphomas were Epstein-Barr encoded RNA in situ hybridization (EBER-ISH) positive. PBL was the most common EBV-driven lymphoma (median CD4⁺ count = 147 cells/mm³), with the highest Ann Arbor staging.

Conclusion: These findings suggest that EBV infection is among the primary factors contributing to PBL oncogenesis in HIV-positive patients. Patients with PBL presented with CD4⁺ T-cell counts of <400 cells/mm³. Patients with HIV infection had a lower overall survival rate compared to HIV-negative patients, irrespective of lymphoma type.