Although efficiently managed by cART, chronic HIV infection remains associated with a high incidence of malignant lymphomas. This diverse group of tumors presents considerable challenges in research, diagnosis, and treatment due to their complex pathogenesis, heterogeneous tumor microenvironment, and frequently aggressive clinical behavior. In this review, we examine the multifactorial pathogenesis of lymphomas arising in people living with HIV (PLWH), encompassing both direct and indirect oncogenic mechanisms. We summarize the key histopathological features and microenvironmental characteristics that may influence therapeutic responses. Current treatment strategies approved for the treatment of lymphomas in PLWH are showing outcomes comparable with those observed in patients without HIV. Notably, the immune reconstitution achieved through cART has renewed interest in immunotherapeutic approaches for HIV-associated lymphomas, with several strategies under clinical investigation. However, progress in the diagnosis and management of these malignancies is hindered by fragmented research efforts and the frequent exclusion of PLWH from pivotal clinical trials. Coordinated efforts are essential to overcome these barriers, reduce lymphoma incidence, and improve survival outcomes in this vulnerable population.
尽管通过联合抗逆转录病毒疗法（cART）得到有效控制，慢性HIV感染仍与恶性淋巴瘤的高发病率密切相关。这类肿瘤因其复杂的发病机制、异质性的肿瘤微环境以及常具侵袭性的临床行为，在研究、诊断和治疗方面均构成显著挑战。本文综述了HIV感染者（PLWH）发生淋巴瘤的多因素致病机制，涵盖直接与间接致癌途径。我们总结了可能影响治疗反应的关键组织病理学特征及微环境特点。目前获批用于HIV感染者淋巴瘤的治疗策略已显示出与HIV阴性患者相当的疗效。值得注意的是，通过cART实现的免疫重建重新激发了人们对HIV相关淋巴瘤免疫治疗方法的兴趣，已有多种策略进入临床研究阶段。然而，这些恶性肿瘤的诊断和治疗进展仍因研究力量分散以及HIV感染者常被排除在关键临床试验之外而受到阻碍。必须通过协同努力来突破这些障碍，降低淋巴瘤发病率，并改善这一脆弱群体的生存预后。
肿瘤(癌症)患者之家