{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:27:36Z","timestamp":1760056056522,"version":"build-2065373602"},"reference-count":33,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,9,28]],"date-time":"2025-09-28T00:00:00Z","timestamp":1759017600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Lymphomas remain a significant cause of morbidity and mortality among patients living with HIV. Although the introduction of antiretroviral therapy has led to a reduction in the incidence of AIDS-related lymphomas (ARL) and an overall improvement in prognosis, these malignancies continue to pose a considerable clinical challenge. Beyond the inherent complexity of lymphoma treatment itself, the management of comorbidities, particularly infections, represents a therapeutic obstacle. Here, we review the published evidence on ARL complicated by COVID-19. Despite the fact that nearly 800 million confirmed cases of SARS-CoV-2 infection have been reported so far, only five cases of ARL and COVID-19 have been published, among whom most patients experienced a mild course of SARS-CoV-2 infection, with only one case progressing to severe COVID-19 that required oxygen therapy and prolonged hospitalization. Additionally, we present another case of a 49-year-old male patient with newly diagnosed ARL, Epstein\u2013Barr virus (EBV)-positive, diffuse large B-cell lymphoma, not otherwise specified, complicated by prolonged SARS-CoV-2 infection. Although initially asymptomatic, the patient subsequently experienced transient respiratory failure. Despite administration of molnupiravir, both SARS-CoV-2 antigen and RT-qPCR tests remained positive for a minimum of 113 days. The prolonged SARS-CoV-2 infection, in conjunction with other opportunistic infections, impeded the delivery of adequate chemotherapy dose intensity and contributed to disease progression and ultimately the patient\u2019s death. This case and review of the literature underscores the diversity of the clinical course of SARS-CoV-2 infection in patients with ARL and highlights the associated challenges in delivering optimal anti-lymphoma therapy in those patients.<\/jats:p>","DOI":"10.3390\/ph18101461","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T10:49:34Z","timestamp":1759142974000},"page":"1461","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Challenges in the Treatment of HIV-Related Lymphomas Complicated by COVID-19: Case Study and Review of the Literature"],"prefix":"10.3390","volume":"18","author":[{"given":"Kinga","family":"Siewiorek","sequence":"first","affiliation":[{"name":"Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Banacha 1a Str., 02-097 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7519-9507","authenticated-orcid":false,"given":"Marcin","family":"Jasi\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Banacha 1a Str., 02-097 Warsaw, Poland"},{"name":"Doctoral School, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B\u0142a\u017cej","family":"Izdebski","sequence":"additional","affiliation":[{"name":"Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Banacha 1a Str., 02-097 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0868-0018","authenticated-orcid":false,"given":"Maciej","family":"Przybylski","sequence":"additional","affiliation":[{"name":"Chair and Department of Medical Microbiology, Medical University of Warsaw, Cha\u0142ubi\u0144skiego 5 Str., 02-004 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ma\u0142gorzata","family":"Kobylecka","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Medical University of Warsaw, Banacha 1a Str., 02-097 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanna","family":"M\u0105czewska","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Medical University of Warsaw, Banacha 1a Str., 02-097 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krzysztof","family":"Jamroziak","sequence":"additional","affiliation":[{"name":"Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Banacha 1a Str., 02-097 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanna","family":"Drozd-Soko\u0142owska","sequence":"additional","affiliation":[{"name":"Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Banacha 1a Str., 02-097 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,28]]},"reference":[{"key":"ref_1","unstructured":"WHO COVID-19 Dashboard (2021, April 21). Geneva: World Health Organization. Available online: https:\/\/covid19.who.int\/."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2799","DOI":"10.1007\/s00277-021-04656-z","article-title":"Clinical characteristics and outcomes of patients with haematologic malignancies and COVID-19 suggest that prolonged SARS-CoV-2 carriage is an important issue","volume":"100","author":"Arcani","year":"2021","journal-title":"Ann. Hematol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1159\/000522436","article-title":"COVID-19 in Patients with Hematologic Malignancies: Outcomes and Options for Treatments","volume":"145","author":"Martinez","year":"2022","journal-title":"Acta Haematol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e002630","DOI":"10.1136\/jitc-2021-002630","article-title":"COVID-19 in immunocompromised populations: Implications for prognosis and repurposing of immunotherapies","volume":"9","author":"Goldman","year":"2021","journal-title":"J. Immunother. Cancer"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Pula, B., Pruszczyk, K., Pietrusza, E., Morawska, M., Piszczek, W., Kalicinska, E., Szeremet, A., Tryc-Szponder, J., Wasik-Szczepanek, E., and Drozd-Sokolowska, J. (2022). Outcome of SARS-CoV-2-Infected Polish Patients with Chronic Lymphocytic Leukemia. Cancers, 14.","DOI":"10.3390\/cancers14030558"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1111\/bjh.17937","article-title":"Key findings from the UKCCMP cohort of 877 patients with haematological malignancy and COVID-19: Disease control as an important factor relative to recent chemotherapy or anti-CD20 therapy","volume":"196","author":"Booth","year":"2022","journal-title":"Br. J. Haematol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1007\/s15010-023-02169-7","article-title":"Need for ICU and outcome of critically ill patients with COVID-19 and haematological malignancies: Results from the EPICOVIDEHA survey","volume":"52","author":"Lahmer","year":"2024","journal-title":"Infection"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Hus, I., Szymczyk, A., Manko, J., and Drozd-Sokolowska, J. (2023). COVID-19 in Adult Patients with Hematological Malignancies-Lessons Learned after Three Years of Pandemic. Biology, 12.","DOI":"10.3390\/biology12040545"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1093\/infdis\/jiaa666","article-title":"Prolonged Severe Acute Respiratory Syndrome Coronavirus 2 Replication in an Immunocompromised Patient","volume":"223","author":"Baang","year":"2021","journal-title":"J. Infect. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2523","DOI":"10.2169\/internalmedicine.9136-21","article-title":"Prolonged COVID-19 in an Immunocompromised Patient Treated with Obinutuzumab and Bendamustine for Follicular Lymphoma","volume":"61","author":"Ueda","year":"2022","journal-title":"Intern. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1080\/23744235.2022.2055136","article-title":"Prolonged SARS-CoV-2 shedding in a person living with advanced HIV and diffuse large B-cell lymphoma: A case report","volume":"54","author":"Maan","year":"2022","journal-title":"Infect. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1522","DOI":"10.1093\/infdis\/jiab075","article-title":"Long-Term Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infectiousness Among Three Immunocompromised Patients: From Prolonged Viral Shedding to SARS-CoV-2 Superinfection","volume":"223","author":"Tarhini","year":"2021","journal-title":"J. Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e144","DOI":"10.1093\/cid\/ciac077","article-title":"Prolonged Shedding of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at High Viral Loads Among Hospitalized Immunocompromised Persons Living With Human Immunodeficiency Virus (HIV), South Africa","volume":"75","author":"Meiring","year":"2022","journal-title":"Clin. Infect. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1007\/s12015-020-10107-5","article-title":"Usefulness of Plasma SARS-CoV-2 RNA Quantification by Droplet-based Digital PCR to Monitor Treatment Against COVID-19 in a B-cell Lymphoma Patient","volume":"17","author":"Szwebel","year":"2021","journal-title":"Stem Cell Rev. Rep."},{"key":"ref_15","first-page":"e22710","article-title":"Different Course of SARS-CoV-2 Infection in Two Adolescents With Other Immunosuppressive Factors","volume":"14","author":"Kuczborska","year":"2022","journal-title":"Cureus"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"377","DOI":"10.2174\/1570162X19666210423124839","article-title":"Outcome of a HIV Positive Patient Infected with COVID-19 After an Autologous Bone Marrow Transplantation: A Case Report","volume":"19","author":"Mardani","year":"2021","journal-title":"Curr. HIV Res."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Padurariu-Covit, M.D., Andreescu, M., Niculet, E., Plesea-Condratovici, A., and Arbune, M. (2025). Managing HIV-Associated Hodgkin Lymphoma During the COVID-19 Pandemic: Case Report and Literature Review. Viruses, 17.","DOI":"10.3390\/v17030404"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1136\/gut.45.2.172","article-title":"Endoscopic assessment of oesophagitis: Clinical and functional correlates and further validation of the Los Angeles classification","volume":"45","author":"Lundell","year":"1999","journal-title":"Gut"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2375","DOI":"10.1182\/blood-2016-01-643569","article-title":"The 2016 revision of the World Health Organization classification of lymphoid neoplasms","volume":"127","author":"Swerdlow","year":"2016","journal-title":"Blood"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3059","DOI":"10.1200\/JCO.2013.54.8800","article-title":"Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: The Lugano classification","volume":"32","author":"Cheson","year":"2014","journal-title":"J. Clin. Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"International Non-Hodgkin\u2019s Lymphoma Prognostic Factors Project (1993). A predictive model for aggressive non-Hodgkin\u2019s lymphoma. N. Engl. J. Med., 329, 987\u2013994.","DOI":"10.1056\/NEJM199309303291402"},{"key":"ref_22","unstructured":"Freifeld, A. (2025, September 23). NCCN Best Practices Guidance: Management of COVID-19 Infection in Patients with Cancer (March 2021). Available online: https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/infections.pdf."},{"key":"ref_23","unstructured":"European Society for Medical Oncology (2020). Cancer Patient Management During the COVID-19 Pandemic, European Society for Medical Oncology."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2061","DOI":"10.1038\/s41375-025-02649-9","article-title":"Post-pandemic recommendations for the management of COVID-19 in patients with haematological malignancies or undergoing cellular therapy, from the European Conference on Infections in Leukaemia (ECIL-10)","volume":"39","author":"Cesaro","year":"2025","journal-title":"Leukemia"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e150","DOI":"10.1002\/hem3.150","article-title":"Human immunodeficiency virus-associated Lymphomas: EHA-ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up","volume":"8","author":"Hubel","year":"2024","journal-title":"Hemasphere"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1016\/j.ctrv.2005.05.007","article-title":"Tolerability and safety of rituximab (MabThera)","volume":"31","author":"Kimby","year":"2005","journal-title":"Cancer Treat. Rev."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1002\/ajh.26209","article-title":"Prolonged in-hospital stay and higher mortality after COVID-19 among patients with non-Hodgkin lymphoma treated with B-cell depleting immunotherapy","volume":"96","author":"Dulery","year":"2021","journal-title":"Am. J. Hematol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e419","DOI":"10.1016\/S2665-9913(21)00059-X","article-title":"COVID-19 outcomes in patients with inflammatory rheumatic and musculoskeletal diseases treated with rituximab: A cohort study","volume":"3","author":"Avouac","year":"2021","journal-title":"Lancet Rheumatol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1182\/bloodadvances.2021005691","article-title":"A prognostic model for patients with lymphoma and COVID-19: A multicentre cohort study","volume":"6","author":"Visco","year":"2022","journal-title":"Blood Adv."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1056\/NEJMoa2116044","article-title":"Molnupiravir for Oral Treatment of COVID-19 in Nonhospitalized Patients","volume":"386","author":"Musungaie","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1002\/ijc.34442","article-title":"Molnupiravir is effective in patients with haematological malignancies","volume":"153","author":"Bolkun","year":"2023","journal-title":"Int. J. Cancer"},{"key":"ref_32","first-page":"CD013705","article-title":"Rapid, point-of-care antigen and molecular-based tests for diagnosis of SARS-CoV-2 infection","volume":"8","author":"Dinnes","year":"2020","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e0046921","DOI":"10.1128\/JCM.00469-21","article-title":"Can Testing Predict SARS-CoV-2 Infectivity? The Potential for Certain Methods To Be Surrogates for Replication-Competent Virus","volume":"59","author":"Binnicker","year":"2021","journal-title":"J. Clin. Microbiol."}],"container-title":["Pharmaceuticals"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8247\/18\/10\/1461\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T08:07:04Z","timestamp":1759997224000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8247\/18\/10\/1461"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,28]]},"references-count":33,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["ph18101461"],"URL":"https:\/\/doi.org\/10.3390\/ph18101461","relation":{},"ISSN":["1424-8247"],"issn-type":[{"type":"electronic","value":"1424-8247"}],"subject":[],"published":{"date-parts":[[2025,9,28]]}}}