Causes and risk factors
There are no well-defined risk factors for development of Hodgkin's lymphoma and its causes remain unknown. Certain associations have been noted that provide clues to possible etiologic factors. Familial aggregation may imply genetic factors, but other epidemiologic findings suggest an abnormal response to an infective agent. Both factors may play a role in the pathogenesis of the disease.
- Same-sex siblings of patients with Hodgkin?s disease have a 10 times higher risk for the disease. Patient-child combinations are more common than spouse pairings.
- The monozygotic twin sibling of a patient with Hodgkin?s disease has a 99 times higher risk of developing Hodgkin?s disease than a dizygotic twin sibling of a patient with Hodgkin?s disease.
- Higher risk for Hodgkin?s disease is associated with few siblings, single-family houses, early birth order, and fewer playmates all of which decrease exposure to infectious agents at an early age.
EBV: Epstein-Barr virus has been implicated in the etiology of Hodgkin?s disease by both epidemiologic and serologic studies, as well as by the detection of the EBV genome in 20%-80% of tumor specimens.
- HIV: Hodgkin?s disease in HIV-positive patients is associated with an advanced stage and poor therapeutic outcome. However, there have been no conclusive studies regarding the possible increased frequency of Hodgkin?s disease in patients with human immunodeficiency (HIV) infection.
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