More than 20 years ago the introduction of highly active antiretroviral therapy (ART) for treatment of HIV infection was rapidly followed by enormous population-wide reductions in mortality and morbidity in people living with HIV, including reductions in HIV-associated cancers such as non-Hodgkin lymphoma and Kaposi sarcoma. In clinical cohorts, the risk of non-Hodgkin lymphoma and Kaposi sarcoma decreased drastically within months of ART commencement. ^,  In a subsequent randomised controlled trial, immediate ART initiation reduced the incidence of these two human herpesvirus-related cancers compared with deferred ART initiation. By complete contrast with the pattern seen for non-Hodgkin lymphoma and Kaposi sarcoma, the incidence of anal cancer related to high-risk human papillomavirus (HR-HPV) increased in people living with HIV in the years following the introduction of ART. The annual incidence of anal cancer reached 103 cases per 100 000 person-years in some HIV populations after 1996, from 15 cases per 100 000 person-years before 1996. Until the late 2000s, multiple population-based studies have shown that anal cancer incidence has not declined in people living with HIV, despite the enormous improvements in ART and treatment coverage and the consequent improvement of immune function. Therefore, this question remains: why does anal cancer seem to be so resistant to the effects of improved immune function brought about by ART?

中文翻译：

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艾滋病毒治疗和肛门癌：日益清晰。

20多年前，采用高活性抗逆转录病毒疗法（ART）来治疗HIV感染，随后迅速在全人群范围内大幅降低了HIV感染者的死亡率和发病率，包括降低了与HIV相关的癌症，例如霍奇金淋巴瘤和卡波济肉瘤。在临床队列中，非霍奇金淋巴瘤和卡波西肉瘤的风险在抗逆转录病毒治疗开始后的几个月内急剧下降。^， 在随后的一项随机对照试验中，与延缓抗逆转录病毒治疗相比，立即抗逆转录病毒治疗降低了这两种人类疱疹病毒相关癌症的发病率。与非霍奇金淋巴瘤和卡波西肉瘤所见模式完全相反，在引入抗逆转录病毒疗法后的几年中，与高危人类乳头瘤病毒（HR-HPV）有关的肛门癌的发病率增加。1996年以后，在某些HIV人群中，肛门癌的年发病率达到每10万人年103例，而1996年之前为每10万人年15例。直到2000年代后期，多项基于人群的研究表明，肛门癌的发病率尽管抗逆转录病毒疗法和治疗覆盖面得到了极大的改善，并因此改善了免疫功能，但艾滋病毒感染者的数量并没有下降。