Burkitt lymphoma occurs in HIV positive patients with variable number of CD4-cells.
A student once asked me that question, very interesting indeed. The whole point of the "AIDS defining illness/condition" I believe is to assist in the clinical diagnosis of AIDS and to be able to predict a prognosis. There are more than 800 AIDS related conditions, the CDC and WHO came up with a list of AIDS defining illnesses which is composed of the most common clinical conditions that are associated with AIDS. Of course these can also occur in non AIDS cases, but their appearance merits further investigation and ruling out of AIDS as a causative factor.
While I agree with you Lawrence that pharmaceutical companies are shady, anything but transparent , and greatly influence the policy decision making in many organizations, I tend to disagree with you that patients with AIDS defining illnesses (ADI) are not at all subjected to antiretrovirals unless HIV had been isolated and diagnosed. I believe ADIs were simply put to call the physicians attention to the probability of HIV infection, they also served as epidemiological and prognostic factors.
Actually, how can HIV be a hypothesis? if the pathogen and its cytotoxic effects have been isolated and characterized, then it can be formally estabilshed. I would understand if we were talking about H1N1or Ebola, but HIV had been researched thoroughly, dont you agree?
I must admit, I was intrigued. Following your links I stumbled across this, and you do have an interesting argument, but I am fairly confident that many papers were successful in isolating HIV from patients blood, even we are working with an isolated virus strain...but anyways, i will gather my evidence, I just dont want to hijack the question thread..sorry Marcio :)
https://www.google.hu/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0CCQQFjAA&url=http%3A%2F%2Fwww.theperthgroup.com%2FRESPONSE%2FEPEIsolationSACCourt1.ppt&ei=go2RVLuFBcytUZK5gYAB&usg=AFQjCNHRlY1l_3ZfrozYUp7X9kf5eaIsUQ&sig2=_BQuD5Vsyx9AfuvAMNkyfg
I think Burkitt's lymphoma can be found in patients who are either HIV+ or HIV-, and since HIV-1 destroys the ability of the immune system to respond to pathogens and cancers alike over time, then it would be logical to predict that HIV infection increases the chance of developing Burkitt's lymphoma. But I'm sure there are epidemiology papers looking and HIV and Burkitt's lymphoma incidence on pubmed to settle this point. On an unrelated note, I have never heard of the NY Insitute of Med Research and neither is google. So I seriously doubt the credibility of the author claiming to be from said institute.
I understand that HIV+ patients have a higher risk of developing Burkitt lymphoma and the clinical presentation is generally more disseminated than in endemic and sporadic variants of Burkitt's lymphoma. Still, I am reluctant in considering it an "AIDS defining condition". A recent study compared the compared the outcome and toxicity of HIV+ and HIV- patients with BL who were treated with an intensive immunochemotherapy - (Cancer 2013;119:1660–8). Although myelossupression and mucositis were more common in HIV infected patients, the response rate, relapse rate and overall survival were not significantly different in the two groups.
First we must define what an AIDS defining condition is: it is an opportunistic event which, in conjunction with a positive HIV serology, categorize a patient as suffering from AIDS. I believe Burkitt's lymphoma (sporadic variant) can be considered an AIDS defining condition based on it's viral etiology (EBV). Immunity against EBV is compromised among HIV positive patients, so it is conceivable that the occurrence of Burkitt's lymphoma in such population is a sign of advanced disease and opportunistic in its genesis.
Not to forget that HIV has a well known effect of B cell dysregulation, beside the effects on the cellular immunity, hence, increasing the chance of Burkitts lymphoma.
On another note, and not to hijack this thread, I have opened a question to end this debate once and for all :)
https://www.researchgate.net/post/HIV_and_lack_of_Electron_Microscopy_evidence
HIV is an infection that is triggered by Cell deficiency. And this kind of lymphoma is associated with this kind of deficiency. Other word HIV is like a latent infection which is waiting for cell deficiency (of Lymphoma) to be presented. So one of the main criteria of HIV must be Lymphoma. This is very simple!
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