The number of people living with HIV infection has been increasing globally. Administration of antiretroviral therapy is effective in controlling the infection for most patients and, as a consequence, people living with HIV (PLWH) now often have a long life expectancy. However, their risk of developing cancer — most notably virus-related cancers — has been increasing. To date, few studies have assessed the risk of genitourinary cancers in PLWH, and robust scientific data on their treatment-related outcomes are lacking. Previous studies have noted that PLWH are at a reduced risk of prostate cancer; however, low adoption and/or availability of prostate cancer screening among these patients might be confounding the validity of this finding. In genitourinary cancers, advanced stage at diagnosis and reduced cancer-specific mortality have been reported in PLWH. These data likely reflect, at least in part, the inequity of health care access for PLWH. Notably, systemic chemotherapy and/or radiotherapy could decrease total CD4⁺ cell counts, which could, therefore, increase the risk of morbidity and mortality from cancer treatments in PLWH. Immune checkpoint inhibitors have become the therapeutic backbone for many advanced malignancies in the general population; however, most studies validating their efficacy have excluded PLWH owing to concerns of severe adverse effects from immune checkpoint inhibitors themselves and/or related to their immunosuppressed status. To our knowledge, no genitourinary cancer survivorship programme exists that specifically caters to the needs of PLWH. By including PLWH in ongoing cancer trials, we can gain invaluable insights that will help to improve cancer care specifically for PLWH.

全球艾滋病毒感染者人数一直在增加。抗逆转录病毒治疗可以有效控制大多数患者的感染，因此，艾滋病毒感染者 (PLWH) 现在通常具有较长的预期寿命。然而，他们患癌症（尤其是与病毒相关的癌症）的风险一直在增加。迄今为止，很少有研究评估艾滋病毒感染者患泌尿生殖系统癌症的风险，并且缺乏关于其治疗相关结果的可靠科学数据。之前的研究已经指出，艾滋病病毒感染者患前列腺癌的风险较低。然而，这些患者中前列腺癌筛查的采用率和/或可用性较低，可能会混淆这一发现的有效性。据报道，在泌尿生殖系统癌症中，PLWH 的诊断已处于晚期并且癌症特异性死亡率降低。这些数据可能至少部分反映了艾滋病病毒感染者获得医疗保健的不平等。值得注意的是，全身化疗和/或放疗可能会减少总 CD4 ⁺细胞计数，因此可能会增加 PLWH 癌症治疗的发病率和死亡率风险。免疫检查点抑制剂已成为普通人群中许多晚期恶性肿瘤的治疗支柱；然而，大多数验证其疗效的研究都排除了感染者，因为担心免疫检查点抑制剂本身和/或与其免疫抑制状态相关的严重副作用。据我们所知，目前还没有专门满足艾滋病患者需求的泌尿生殖系统癌症生存计划。通过将 PLWH 纳入正在进行的癌症试验，我们可以获得宝贵的见解，这将有助于改善专门针对 PLWH 的癌症护理。