BackgroundAntiretroviral therapy has reduced the incidence and mortality of AIDS‐defining malignancies (ADM); however, non–AIDS‐defining malignancies (NADM) are a major cause of death among people living with HIV (PLWH) today. Though current guidelines suggest that PLWH should receive the same treatment as the general population, there are limited studies focused on how HIV status affects the prognosis of cancers. The present study aimed to investigate the characteristics and prognosis of malignant diseases among PLWH in Japan.MethodsPatients with HIV diagnosed with malignant diseases at our institution between 2011 and 2021 were retrospectively reviewed.ResultsThere were 205 patients who were diagnosed with malignancies. Of these, 87 (42.4%) were diagnosed with ADM and 118 (57.6%) were diagnosed with NADM. Among 69 patients who received chemotherapy for ADM, 24 (34.8%) developed AIDS‐defining opportunistic infections during treatment. In contrast, only one (1.8%) of the 56 patients administered chemotherapy for NADM developed AIDS‐defining opportunistic infections. Complications of opportunistic infections at diagnosis of malignancies, low CD4+ T‐cell count, positive HIV RNA, and nonadministration of antiretroviral therapy were associated with 5‐year overall survival among patients with malignant lymphomas. However, the variables associated with HIV did not affect NADM prognosis.ConclusionsIn this analysis, HIV status had a small impact on the prognosis of malignant diseases in PLWH. Few patients with NADM developed AIDS‐defining opportunistic infections after receiving chemotherapy.

中文翻译：

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HIV 状况对日本 HIV 感染者恶性肿瘤预后的影响

背景抗逆转录病毒治疗降低了艾滋病定义的恶性肿瘤（ADM）的发病率和死亡率；然而，非艾滋病定义的恶性肿瘤 (NADM) 是当今艾滋病毒感染者 (PLWH) 死亡的主要原因。尽管目前的指南建议艾滋病病毒感染者应接受与普通人群相同的治疗，但针对艾滋病毒状况如何影响癌症预后的研究有限。本研究旨在调查日本PLWH中恶性疾病的特征和预后。方法对2011年至2021年在我机构诊断为恶性疾病的HIV感染者进行回顾性分析。结果诊断为恶性肿瘤的患者205例。其中，87 例（42.4%）被诊断为 ADM，118 例（57.6%）被诊断为 NADM。在 69 名接受 ADM 化疗的患者中，24 名（34.8%）在治疗期间出现了艾滋病定义的机会性感染。相比之下，在 56 名接受 NADM 化疗的患者中，只有 1 名（1.8%）出现了艾滋病定义的机会性感染。恶性肿瘤诊断时机会性感染的并发症、低 CD4+T 细胞计数、HIV RNA 阳性和未接受抗逆转录病毒治疗与恶性淋巴瘤患者的 5 年总生存率相关。然而，与HIV相关的变量并不影响NADM预后。结论在本次分析中，HIV状态对PLWH中恶性疾病的预后影响较小。很少有 NADM 患者在接受化疗后出现艾滋病定义的机会性感染。