HIV Infection Clinical Trial
Official title:
French Cohort of HIV Associated Lymphomas
The incidence of lymphomas is increased among HIV infected patients. In 70 % of cases, those
are Non Hodgkin's lymphomas (NHL) and Hodgkin lymphomas (HL) in 30% of cases. In France,
their incidence is estimated to 100 cases per year (data from the "Base de données
Hospitalière Française sur l'Infection à VIH" (FHDH)). The main mechanisms involved in
lymphomagenesis are immune dysfunction, involvement of oncogenic viruses (Epstein-Barr (EBV)
and HHV8) and molecular oncogenic events. A better understanding of these different pathways,
give the possibility to design specific treatments. The treatment of these lymphomas is not
standardized. A prospective study of patients with HIV associated lymphoid malignancies is an
innovating tool to answer epidemiological, physiopathological and therapeutic questions. We
propose a prospective multicentric study of these patients.
The main objectives of this prospective study are to:
- evaluate the incidence, characterise clinically and histologically NHL and HL cases
associated to HIV
- perform an observational study of the treatment and outcome of these patients out of the
context of clinical trials,
- study the differentiation and activation of B-cell populations,
- better understand the role of specific T cell responses in the control of EBV infection,
- allow other biological studies from the ANRS group " Lymphome et VIH ".
The recruitment of 40 cases per year is expected. The length of inclusions is 7 years. The
follow-up will be of 2 years. Clinical, pathological and biological data at diagnosis and
during follow-up will be collected. This will allow characterizing the lymphoma, the HIV
infection, the antitumoral treatments and the outcome of lymphoma. Biological samples will be
centralized to collect cell, DNA, RNA, plasma, serum and tumour collections (Y.Taoufik, S
Prevot* ). To better understand the EBV infection and lymphomagenesis in HIV infection, we
propose to follow the viral load and the molecular characteristics of EBV in PBMC, plasma and
tumour (P.Morand* , V.Boyer* ), to investigate the EBV-T cell responses (G.Carcelain) and the
presence and reactivation of EBV in peripheral B cells (C.Amiel* , JC Nicolas) and in tumoral
samples (M.Raphael* , I.Joab* ). The other mechanisms of lymphomagenesis in HIV infection
will be studied by the analysis of the sub-populations of B-cells in terms of activation and
differentiation (Y.Taoufik) and by the characterization of MSI tumours (A.Duval).
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