Lymphoma and HIV

Having HIV weakens the immune system. Over time, a weak immune system means you are more likely to develop illnesses including some cancer types such as lymphoma.

This gives people with HIV a higher risk of developing lymphoma than people who do not have HIV. But it does not mean that every person with HIV will develop lymphoma. In fact, rates of lymphoma in people with HIV are lower now because HIV treatments are more available and more effective.

Lymphoma is a cancer of the lymphatic system. The lymphatic system is part of the body's immune system.

There are two main sub-types of lymphoma: 

• non-Hodgkin lymphoma (NHL)
• Hodgkin lymphoma.

Lymphoma can often be treated very effectively and can be cured in some cases. Lymphoma treatment is now often considered as effective for people who are HIV positive as for people who are HIV negative.

It is routine to have an HIV test after a lymphoma diagnosis. If you are having tests for lymphoma, your doctor will ask you if they can take a blood sample to check for HIV too.

This can be confusing if you have never been tested or thought about a risk of HIV before. But it is important. If you know you have HIV, there are things you can do to manage it. Knowing whether you have HIV helps your cancer team plan safer and more effective treatment for you.

If you are not sure about having an HIV test, your cancer doctor or nurse can talk it through with you. You can find out more about HIV testing from Aidsmap.

People with HIV usually have the same lymphoma treatment as people who do not have HIV. Being HIV positive may increase your risk of some side effects. To reduce this risk and make lymphoma treatment as effective as possible, you will have:

• treatment to control the HIV
• treatments to prevent infections.

Your cancer doctors and HIV doctors will work together to plan your treatment. This may mean you have to travel to a hospital that treats both HIV and lymphoma.

Different types of lymphoma are treated in slightly different ways, but the main treatment is usually chemotherapy with steroids. For some types of lymphoma, you will also have a targeted or immunotherapy drug. Some people will have radiotherapy to treat an area of lymphoma.

Your cancer doctor will explain your treatment plan and together you make a decision about treatment.

Treatment for HIV involves taking daily anti-HIV drugs to reduce the amount and effects of the virus in your body. This is called antiretroviral treatment.

If you are not already on HIV treatment and you are diagnosed with lymphoma, your doctor will talk to you about starting anti-HIV drugs. Effective treatment prevents passing the virus on during sex. Controlling the HIV also helps make your lymphoma treatment more effective and you are less likely to have side effects.

Some anti-HIV drugs are not safe to take with some types of cancer drugs. If you are already taking anti-HIV drugs, your doctor will check that they are safe to take with your lymphoma treatment. They will explain if you need to change your HIV treatment in any way.

You can find out more about HIV treatment from Aidsmap or the Terrence Higgins Trust.

Lymphoma treatment affects the immune system. It can increase your risk of becoming seriously unwell if you catch an infection. During treatment it is important to get any illness treated as soon as possible. Contact your cancer team or the hospital straight away if you have any of the following signs of infection:

• your temperature goes over 37.5°C (99.5°F)
• you suddenly feel unwell, even with a normal temperature
• you have symptoms of an infection
• your temperature goes below 36°C (96.8°F).

Symptoms of an infection include:

• feeling shivery and shaking
• a sore throat
• a cough
• breathlessness
• diarrhoea
• needing to pass urine (pee) a lot, or discomfort when you pass urine.

During chemotherapy or radiotherapy, you may have extra treatments to prevent infections, such as:

• antibiotics
• anti-viral medicines
• anti-fungal medicines.

Treatment to prevent infections is called prophylaxis.

You may also have a drug called G-CSF. You have it as a small injection under the skin. G-CSF encourages your body to make more white blood cells. This helps increase the number of infection-fighting cells in your blood.

HIV and lymphoma are conditions that affect the body’s immune system. Whether you are newly diagnosed or recovering after lymphoma treatment, there are things you can do to:

• protect and improve your immune system and general health
• help yourself recover after lymphoma treatment.

Anti-HIV drugs are most effective if you take them exactly as prescribed without missing any doses. Take your pills at the right times and doses to make sure your treatment is keeping the HIV under control.

You can also take care of your body by making healthy lifestyle choices.

We have information about lifestyle and wellbeing after cancer treatment. You can also find out more about eating well and getting active. 

Aidsmap.com offers information about healthy living and HIV.