Central feature of BL is deregulated Myc, but protection against apoptosis required: EBV genes, lesions in proapoptotic genes, Myc mutations, Bcl6
The high incidence of BL in equatorial Africa is probably a consequence of “cooperation” between Malaria and EBV – increase in fraction of EBV+ cells
HIV increases risk of BL – effect on CD 4+ T cells? This predisposition is not totally dependent on EBV (30% EBV+); mechanism not the same as malaria
In Africa, the combination of HIV, malaria and EBV, all of which predispose to BL could influence the pattern of NHLs occurring there
There are opportunities to cure patients with BL (HIV+/-with simple therapy while learning more about pathogenesis