HIV and non-Hodgkin lymphoma type B in a patient with undetectable viral load

Abstract

Introduction: HIV infection (acquired immunodeficiency virus) continues to be an important public health problem not only in Ecuador but also throughout the world. Cancer is a common presentation in people living with HIV (PLHIV) and represents the main cause of death in this population in most Latin American countries. There are certain cancers that are often not AIDS-defining (acquired immunodeficiency syndrome), however; they are much more common in people living with HIV, such as anal carcinoma, Hodgkin's disease, hepatocellular carcinoma, and bronchial cancer. The risk of cancer in PLHIV depends on many factors such as adequate virological control, prevention of exposure to oncogenic viruses, contact with toxic substances and other factors, so the implementation of early detection programs is essential. The complexity of the oncological management of this population with numerous comorbidities requires close multidisciplinary collaboration, in addition to a greater number of studies evaluating the appearance of various types of AIDS-defining neoplasms in patients with apparent adequate control of the underlying disease.

 Objective: To describe a relevant clinical case in Ecuador related to the area of Infectology, such as the presence of Non-Hodgkin's Lymphoma in a patient with undetectable viral load.

 Material and methods: Presentation of a clinical case, descriptive, retrospective study.

 Results: The case of a 58-year-old patient diagnosed with HIV in 2000 is described, in the last 10 years she has had adequate clinical, virological and pharmacological control, who suddenly started with symptoms linked to a syndrome a few months ago spinal cord compression at the lumbar level characterized by pain, functional impotence of limbs and paresthesia. After complementary studies, the presence of a mass at the medullary level was determined, from which the pertinent diagnostic approach was carried out, initially characterized by imaging studies (PET / CT) showing a lumbar tumor mass associated with multiple retroperitoneal and inguinal lymph nodes. Which were studied giving as a histopathological result the presence of a Non-Hodgkin Lymphoma, an AIDS-defining neoplasm that finally resulted in the death of the patient; The presence of this type of neoplasm after 20 years of HIV detection and especially after more than 10 years of adequate controls and subsequent undetectable viral loads that the patient in question presented, making the presentation meritorious. discussion of her case.

Conclusions: Neoplasms in the context of HIV are quite frequent, both defining and non-defining of AIDS, however they are not common in the context of adequate individualized control of this type of patients, so permanent surveillance and the context clinical in each case are essential.