Non-Hodgkin Lymphoma with Fulminant Evolution in a Patient with HIV Infection Initially in Stage A3 – Case Presentation

HIV infection is associated with an increased risk for the development of hematological malignancies, especially non-Hodgkin lymphoma (NHL), which continues to present aggressive forms despite therapeutic advances.

We present the case of a 49-year-old patient, originally from Ukraine, diagnosed in January 2023 with HIV infection stage A3 according to the Centers for Disease Control and Prevention (CDC) classification. Clinical, paraclinical and histopathological data were retrospectively analyzed to highlight evolutionary and therapeutic peculiarities.

Although the patient promptly initiated antiretroviral therapy (ART), the oncological risk associated with persistent immunosuppression remains significant, according to data in the literature. Eleven months after the diagnosis of HIV infection, he developed systemic symptoms, and investigations confirmed the presence of an aggressive NHL, an entity described as being among the most common HIV-associated malignancies. Despite the rapid institution of specific treatment, the evolution was fulminant, with progressive deterioration and death, a scenario also documented in other cases of aggressive NHL associated with immunosuppression.

This case reflects the severe evolutionary potential of NHL in HIV patients, even in early stages of infection. Early identification of symptoms, prompt evaluation and multidisciplinary management are crucial to improve prognosis, according to international recommendations.