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The success of combined antiretroviral therapy (cART) has transformed HIV infection into a survivable chronic disease in developed countries. Increasingly then, the risks of HIV associated cancers become paramount. Burkitt lymphoma is one of the cancer subtypes highly disproportionately affecting HIV infected patients.Recent conference proceedings appear to corroborate early reports that intensive therapy of HIV-Burkitt lymphoma is feasible and effective. An optimal approach is not defined due to the small numbers of patients in current trials and the absence of comparison studies. Moreover, as breakthroughs in the pathogenesis of lymphoma in general and Burkitt lymphoma in particular suggest that HIV infection plays a significant role, the opportunity for targeted therapy based on differences in biology are wholly untapped.Advances are being made in HIV-Burkitt lymphoma, but future studies need to incorporate our expanding understanding of biology to improve efficacy and reduce toxicity, preferably by integrating a biologic approach to this curable disease.