Treating HIV-Associated Lymphoma

People with HIV infections are at increased risk for non-Hodgkin lymphoma.

In the past, the outlook for people with HIV-associated lymphoma depended largely on their HIV infection. Now that HIV can usually be well controlled with antiretroviral therapy (ART), the outlook depends more on the type and stage of the lymphoma. Many people with HIV-associated lymphoma can be cured.

What types of lymphoma are associated with HIV?

People with HIV infections tend to get more aggressive forms of non-Hodgkin lymphoma (NHL), such as:

• Diffuse large B-cell lymphoma (DLBCL)
• Primary CNS lymphoma
• Burkitt lymphoma

Some less common types of lymphoma are seen mostly in people with HIV. These include:

• Plasmablastic lymphoma
• Primary effusion lymphoma

How has the outlook changed in recent years?

The outlook for people with HIV-associated lymphoma has improved a great deal in recent years, even though people with HIV infections tend to get more aggressive forms of NHL.

Antiretroviral therapy (ART) that is used to treat HIV has helped people better handle lymphoma treatments such as chemotherapy (chemo) and immunotherapy.

Common treatments

Today, people with HIV-associated lymphoma usually get the same kinds of treatment as people without HIV. For example, treatment might involve chemo combined with the monoclonal antibody rituximab.

Common regimens include R-CHOP and DA-EPOCH-R.

If the lymphoma comes back after treatment, you might still be able to get a stem cell transplant or CAR T-cell therapy if your HIV is well controlled.

Taking HIV medicines during lymphoma treatment

Most people continue taking their HIV medicines during lymphoma treatment. This helps keep the HIV under control and helps your immune system recover.

Some HIV medicines can interact with chemo, so your cancer care team may change your HIV medicines during treatment.

Monitoring blood counts and preventing infections

In the past, people with HIV tended to have low blood cell counts to begin with. This was a major problem, because it made it hard to use full doses of chemo for lymphoma treatment.

This problem has improved with ART and drugs that help the body make new blood cells. However, doctors give chemo cautiously and monitor blood counts closely.

You may also get medicines to help prevent infections during treatment.

Learn more

The exact type of treatment you get will depend on your type of lymphoma. For more on how specific types of NHL are treated, see Treating B-Cell Non-Hodgkin Lymphomas.