AIDS-Related Non-Hodgkin's Lymphoma in Sub-Saharan Africa: Current Status and Realities of Therapeutic Approach.

Today AIDS-related non-Hodgkin's lymphoma (AR-NHL) is a significant cause of
morbidity and mortality in HIV-infected patients the world over, and especially
in sub-Saharan Africa. While the overall incidence of AR-NHL since the emergence
of combination antiretroviral therapy (cART) era has declined, the occurrence of
this disease appears to have stabilized. In regions of the world where access to
cART is challenging, the impact on disease incidence is less clear. In the
resource-rich environment it is clinically well recognized that it is no longer
appropriate to consider AR-NHL as a single disease entity and rather treatment of
AIDS lymphoma needs to be tailored to lymphoma subtype. While intensive
therapeutic strategies in the resource-rich world are clearly improving outcome,
in AIDS epicenters of the world and especially in sub-Saharan Africa there is a
paucity of data on treatment and outcomes. In fact, only one prospective study of
dose-modified oral chemotherapy and limited retrospective studies with sufficient
details provide a window into the natural history and clinical management of this
disease. The scarcities and challenges of treatment in this setting provide a
backdrop to review the current status and realities of the therapeutic approach
to AR-NHL in sub-Saharan Africa. More pragmatic and risk-adapted therapeutic

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