Data on MPXV-specific T-cell responses at the single-peptide level remain limited in patients with mpox and in MVA-BN vaccinees. Here, we characterized the breadth and specificity of MPXV-specific T-cell responses at the single-peptide level after in vitro expansion with overlapping 20-mer peptides spanning the MPXV proteins H3L, A35R, and B6R. The study included 28 adult males: 15 with a history of mpox (including 6 with additional MVA-BN vaccination), 7 MVA-BN-only vaccinees, and 6 unexposed participants. All mpox and MVA-BN participants responded to at least one H3L peptide, indicating broad immunogenicity, while responses to A35R and B6R were more common in the mpox group. Notably, the breadth of B6R-specific CD4+ T-cell responses correlated with hybrid immunity (r = 0.6; p = 0.02). Interestingly, MVA-BN and mpox individuals demonstrated distinct immunodominant patterns: H3L_251-270 and H3L_211-230 were mainly recognized among mpox individuals, whereas MVA-BN recognized H3L_221-240 more frequently. High-affinity HLA binding to multiple H3L peptides suggests broad population coverage. Additional immunogenetic analysis revealed a shared TRBV15 clonotype in about 50% of mpox cases. In summary, these findings highlight H3L as a potential vaccine target, guiding the development of next-generation multi-antigen MPXV vaccines to elicit comprehensive T-cell immunity.

This study aimed to identify predictors of serological nonresponse, defined as a less than fourfold decline in VDRL titers at 12 months, and factors associated with higher minimum titers during months 13–24 after treatment, and to assess whether either outcome was associated with the antibiotic regimen. We conducted a retrospective longitudinal cohort study of individuals with early syphilis treated with benzathine penicillin G or doxycycline and followed for 24 months. Predictors of 12-month serological response were assessed using multivariable logistic regression. Factors associated with the lowest log2-transformed VDRL titer recorded during months 13–24 were evaluated using multivariable linear regression. Among the 633 eligible cases, 106 (16.7

People with HIV are up to 100 times more likely to develop anal carcinoma compared to the general population. Diagnosing and treating precursor lesions, specifically high-grade anal dysplasia, can significantly reduce the risk of developing anal carcinoma. This S2k-guideline outlines the factors that increase the likelihood of developing anal carcinoma and its precursors, including advancing age, a low CD4+ T-lymphocyte nadir, active cigarette smoking, receptive anal intercourse, or persistent infection with high-risk (HR) types of human papillomavirus (HPV). Screening is primarily recommended for all men who have sex with men (MSM) and transgender women with HIV starting at age 35, and all people with HIV starting at age 45. After inspection and digital anorectal examination, anal cytology is collected. An HR-HPV test may be performed. If clinical abnormalities are present or if cytology shows "ASC-US or worse", a referral for high-resolution anoscopy (HRA) is indicated. If lesions are found during HRA, a biopsy should be obtained. Anal intraepithelial neoplasia (AIN) grade-III or AIN-II p16-positive correspond to high-grade dysplasia and require treatment. The most strongly recommended therapeutic options are electrocautery, 85% trichloroacetic acid, and surgical excision. Finally, the guideline discusses how these screening recommendations can be applied to individuals without HIV.

Introduction: Current treatment strategy for HIV-associated Burkitt lymphoma (BL) typically rely on intensive chemotherapy regimens modeled on anti-leukemia protocols such as GMALL, LMB, and their regional derivatives. These are often resource-intensive, prolonged, and associated with dose-limiting toxicities, frequent interruptions, and high treatment-related mortality. The “CARMEN” protocol is a dose-dense regimen developed to improve tolerability while maintaining efficacy [Ferreri, Blood Adv 2022]. It includes a 36-day, single-course induction with weekly sequential doses of six anticancer drugs, plus intrathecal chemo, followed by high-dose cytarabine–based consolidation. Favorable safety and efficacy profiles with CARMEN and similar regimens have helped narrow the outcome gap between HIV-pos and HIV-neg patients (pts) with BL. However, systematic comparisons of efficacy across chemo regimens—particularly when stratified by prognostic scores—remain limited. In the absence of feasible prospective comparative trials, the HIV Lymphoma Network of the European Hematology Association launched an international study to assess feasibility and efficacy of GMALL (and its derivatives), CARMEN, and other regimens in HIV-pos pts with BL treated at 19 centers across Germany, Italy, Spain, France, and Croatia. Methods: HIV-pos adults with BL treated between 2005–2024 were included. All pts were eligible regardless of ECOG PS, stage, IPI, BLIPI [Olszewski, JCO 2021], or treatment. Pts with HBV/HCV infection were included; those lost to follow-up within 6 months of diagnosis were excluded. The primary endpoint was overall survival (OS), analyzed by treatment regimen and stratified by IPI (low: 0–1; intermediate: 2–3; high: 4–5) and BLIPI (low: 0; intermediate: 1; high: 2–4). Feasibility and tolerability were assessed by the incidence of treatment-related deaths, dose reductions or interruptions, grade ≥3 non-hematologic toxicities, and grade ≥3 infections. Variables significantly associated with OS were further evaluated using Cox proportional hazards models. Results: Of 247 consecutive HIV-pos pts with BL (median age 43; range 25–68; 227 males), 16 were excluded for early loss to follow-up, leaving 231 for analysis. Of these, 145 received GMALL or derivatives (BFM, BURKIMAB), 41 received CARMEN, 16 received LMB, and 20 received R-CHOP. Nine pts treated with other regimens were excluded from analyses. Baseline characteristics were comparable across groups, except for B symptoms, which were not recorded in the LMB cohort. At a median follow-up of 65 months (range 7–164), 73 pts experienced a PFS event, and 61 died: 41 from lymphoma, 17 from infections, and 2 from second cancers. The 5-yr PFS and OS were 70% (95%CI:69–71) and 71% (95%CI:70–72), respectively. Stratified by treatment regimen, 5-yr OS was 74% (95%CI:73–75) for GMALL and derivatives, 68% (95%CI:66–70) for CARMEN, 79% (95%CI:78–80) for LMB, and 45% (95%CI:25–62) for R-CHOP. IPI data were available for 212 pts (95%). Among 49 with IPI 0–1, only two events occurred, with a 5-yr OS of 95% (95%CI:94–96) and no significant differences across regimens. Among 163 pts with IPI 2–5, the 5-yr OS was 65% (95%CI:64–66), with comparable efficacy among GMALL and derivatives, CARMEN, and LMB, but significantly worse outcomes for R-CHOP. Similar findings were observed using BLIPI stratification. Multivariable analysis identified bulky disease, HIV-RNA levels, gender, and IPI as independent OS predictors. Notably, it confirmed equivalent efficacy among intensified regimens and their superiority over R-CHOP. In terms of feasibility, CARMEN had the most favorable profile: only 5 pts (12%) required dose reductions and 2 (5%) discontinued treatment due to toxicity. In comparison, dose reductions and discontinuations occurred in 30% and 16% of pts on GMALL, and 38% and 16% with LMB. Conclusions: OS rates are encouraging in HIV-pos pts with BL; however, nearly one-third of deaths are still attributable to iatrogenic toxicity. Despite the limitations of a retrospective design, our findings suggest that CARMEN regimen provides outcomes comparable to those of standard intensive protocols (GMALL, its derivatives, and LMB). Efficacy was consistent across all risk subgroups defined by IPI and BLIPI. In addition to its short duration and favorable tolerability, CARMEN may reduce the risk of chronic toxicity and secondary malignancies, owing to its use of single doses of chemotherapeutic agents.

BACKGROUND:More than 115 000 cases of mpox have been confirmed since the onset of a global outbreak in 2022. In addition to global transmission of clade II monkeypox virus (MPXV), the recent spread of clade I has caused a Public Health Emergency of International Concern. The third-generation smallpox vaccine modified vaccinia Ankara-Bavarian Nordic (MVA-BN) was recommended for at-risk populations in 2022, despite a scarcity of data on safety and effectiveness against mpox. METHODS:We did a prospective, multicentre, observational study, enrolling men who have sex with men and transgender people aged 18 years or older with changing sexual partners in Germany (Safety and Effectiveness of MVA-BN Vaccination Against MPXV Infection [SEMVAc]) between July 7, 2022, and Dec 31, 2023, evaluating safety and reactogenicity of one and two doses of subcutaneous MVA-BN. Vaccine effectiveness was estimated using risk ratios from the Kaplan-Meier estimator in an emulated retrospective target trial (Emulated Target Trial for Effectiveness of MVA-BN Vaccination Against mpox Infection in At-risk Individuals [TEMVAc]) from 3027 vaccinated individuals matched (1:1) to 3027 unvaccinated controls. SEMVAc and TEMVAc were registered in the HMA-EMA Catalogue, EUPAS50093, and the German Clinical Trials Register, DRKS00029638, and are complete. FINDINGS:6459 individuals were prospectively enrolled in SEMVAc. Adverse reactions were infrequent (first dose: 0·35% [95% CI 0·20-0·60] and second dose: 0·14% [0·06-0·33]). Local reactions were more frequent after the first dose (70·2% [95% CI 68·5-71·8]) compared with the second dose (56·8% [54·6-59]), as were systemic reactions (first dose, 22·3% [95% CI 20·9-23·9]; second dose, 17·6% [15·9-19·4]). In TEMVAc, 16 mpox cases were reported in vaccinated individuals versus 32 cases in matched unvaccinated individuals (median follow-up 55 days [IQR 23-89]). Effectiveness by 14 days or later after one dose was 57·8% (95% CI 11·8 to 83·0) overall, 84·1% (42·0 to 100) in people without HIV, but 34·9% (-72·8 to 79·0) in people living with HIV. Breakthrough infections were associated with reduced symptoms, compared with infections in unvaccinated individuals. INTERPRETATION:MVA-BN vaccination was safe and well tolerated. One dose of MVA-BN offered protection against mpox but effectiveness was reduced in people living with HIV. Although randomised controlled trials remain the preferred approach for assessing vaccine efficacy, combining prospective and retrospective study designs can be valuable during dynamic public health emergencies. FUNDING:European Medicines Agency. TRANSLATION:For the German translation of the abstract see Supplementary Materials section.

Menschen mit HIV sind im Vergleich zur Allgemeinbevölkerung bis zu 100‐mal häufiger von Analkarzinomen betroffen. Werden Vorläufer, das bedeutet hochgradige anale Dysplasien, diagnostiziert und therapiert, kann das Risiko für das Auftreten eines Analkarzinoms statistisch signifikant reduziert werden. Faktoren für eine höhere Wahrscheinlichkeit für Analkarzinome und deren Vorläufer sind beispielsweise zunehmendes Alter, ein niedriger CD4+ T‐Lymphozyten Nadir, aktives Zigarettenrauchen, rezeptiver Analverkehr oder persistierender Nachweis von Hoch‐Risiko (HR)‐Typen des humanen Papillomavirus (HPV). Eine Screening‐Empfehlung besteht vorwiegend für alle Männer, die Sex mit Männern haben und Transgender‐Frauen mit HIV ab dem 35. Lebensjahr sowie für alle Menschen mit HIV ab dem 45. Lebensjahr. Nach Inspektion und digital rektaler Untersuchung wird eine anale Zytologie angefertigt. Ein HR‐HPV‐Nachweis kann ergänzend erfolgen. Bei klinischen Auffälligkeiten sowie ab „ASC‐US“ ist die Zuweisung zur hochauflösenden Anoskopie indiziert. Stellen sich hierbei Läsionen dar, ist eine histopathologische Diagnosesicherung anzustreben. Bei analen intraepithelialen Neoplasien (AIN) Grad III und AIN II mit p16‐Positivität entspricht der Befund einer hochgradigen Dysplasie und erfordert eine Therapie. Die stärksten Therapieempfehlungen bestehen für die Elektrokaustik, die Anwendung von 85%iger Trichloressigsäure sowie die operative Abtragung. Abschließend wird in dieser Leitlinie darauf eingegangen, wie das Analkarzinom‐Screening auf Menschen ohne HIV übertragen werden kann.

OBJECTIVES:With the near normalization of life expectancy in people living with HIV through antiretroviral therapy, the management of age-related comorbidities has become increasingly important. Non-AIDS-defining cancers now contribute significantly to both morbidity and mortality in this population, with non-small cell lung cancer (NSCLC) being one of the leading causes of cancer-related deaths among people living with HIV. METHODS:Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of NSCLC in the general population. However, people living with HIV have been largely excluded from pivotal clinical trials, resulting in limited evidence regarding safety and efficacy in this population. This review summarizes the main available literature on ICI therapy in people living with HIV with NSCLC. RESULTS:The presented data from retrospective analyses and cohort studies suggest that people living with HIV benefit from ICI therapy, with similar response rates and survival outcomes as people living without HIV. The risk of immune-related adverse events in people living with HIV was reported to be comparable to people living without HIV. Importantly, no significant effects of ICI on HIV viral load or CD4+ T cell count were reported. CONCLUSIONS:ICI therapy appears to be both safe and effective in people living with HIV with NSCLC. Optimal management of this patient population requires close interdisciplinary collaboration between oncologists and HIV care specialists. To enhance our understanding, broader inclusion of people living with HIV in clinical trials and the conduct of dedicated HIV-specific studies would be essential.

People with HIV (PWH) who have chronic hepatitis B virus (HBV) coinfection are at increased risk of also having hepatitis D virus (HDV) infection given the shared transmission pathways. The current prevalence of HDV in Germany among people with HIV/HBV, however, is unknown. The aim of this study was to determine the percent with HDV screening as well as the current HDV prevalence among German PWH with HBV coinfection and underlying risk factors for HDV infection. 21 German HIV treatment centers (6 university clinics, 15 private practices) recruited all people with a confirmed HIV diagnosis and a positive hepatitis B surface antigen for more than 6 months, aged ≥ 18 years, and actively in care on December 31, 2023. We assessed the percent with anti-HDV antibody testing in the total cohort. In addition, we calculated the prevalence of individuals who ever had an anti-HDV positive serology (i.e., past/current infection) and the prevalence of individuals whose last HDV RNA result was positive (i.e., active infection). Overall, 458 PWH with HBV coinfection were included in the analysis. 17

Human mpox, caused by the mpox virus, is a reemerging viral zoonosis that has gained global attention due to recent Clade IIb outbreaks outside of Africa, as well as ongoing Clade Ia and Ib outbreaks in the Democratic Republic of Congo (DRC) and surrounding regions. Since the start of these outbreaks in 2022, approximately 160,000 people have been affected across more than 100 countries. People with human immunodeficiency virus (HIV; hereafter referred to as PWH) have been disproportionately affected, accounting for approximately 50% of all cases. Mpox is typically a self-limiting illness causing smallpox-like symptoms lasting 2–4 weeks, which can cause significant pain and morbidity. People with uncontrolled or advanced HIV face an elevated risk of severe mpox, secondary complications, and worse outcomes. Vaccination with second- and third-generation vaccinia-based smallpox vaccines has emerged as an important tool in mpox prevention, alongside behavioural modification to mitigate risk. However, only the third-generation, live-attenuated, non-replicating vaccine, modified vaccinia Ankara (MVA-BN [Bavarian Nordic]), is approved for use in PWH. Real-world estimates suggest that two doses of MVA-BN administered as pre-exposure prophylaxis confers vaccine effectiveness in the range of 66–90%. Additionally, MVA-BN has been widely demonstrated to have an acceptable safety profile. This narrative review explores the changing epidemiology, clinical manifestations, and outcomes of mpox in PWH. We also summarise evidence from the Clade IIb outbreaks on the effectiveness and safety of MVA-BN among PWH. Despite progress in our understanding, knowledge gaps persist regarding vaccine performance in individuals with advanced immunosuppression. Furthermore, due to the emergent nature of outbreaks in the DRC and surrounding areas, limited information is available regarding implications for PWH in the context of Clade Ia and Ib. We aim to provide healthcare providers, community stakeholders, and researchers with a foundational understanding of mpox in PWH and the role of MVA-BN in mpox prevention among this group, while highlighting areas of uncertainty. These insights may be helpful in the planning of future research and to inform strategies for the prevention and management of mpox among PWH, particularly those with advanced or uncontrolled HIV.

Background:Integrase strand-transfer inhibitors (INSTI) are a key part of contemporary antiretroviral therapy (ART). Raltegravir (RAL) was the first INSTI and remains recommended for some people with HIV. We investigated all-cause mortality between RAL-based ART and other INSTIs in the RESPOND cohort consortium among both ART-naïve and treatment experienced individuals. Methods:RESPOND, a multicenter prospective cohort study, includes approximately 40,000 adults (≥18 years) with HIV from 17 cohorts across Europe and Australia. Individuals eligible for inclusion into RESPOND had ≥1 clinical visit at a site participating in RESPOND after January 01, 2012, and a CD4 count and HIV viral load measurement available at inclusion. Participants in RESPOND who started their first INSTI between JAN 01, 2012 and DEC 31, 2021 were included. All-cause mortality among those starting RAL was compared to those starting any other INSTI using Cox proportional hazards regressions: one model adjusting for age and another weighted by inverse probability of treatment weights (IPTW). Predictors of starting RAL were estimated by logistic regression. Findings:Among 20,349 participants starting an INSTI (15,429 (75.8%) male, 4879 (24.0%) female, and 41 (0.2%) transgender), 938 (4.6%) died during 94,677 person-years of follow-up (PYFU). Crude mortality rates (MR) were higher for participants starting RAL (MR 12.9 per 1000 PYFU; 95% CI 11.5-14.5) than other INSTIs (MR 9.1 per 1000 PYFU; 95% CI 8.4, 9.8). Starting RAL was significantly associated with higher mortality when controlling for age (adjusted hazard ratio (aHR) 1.43; 95% CI 1.25, 1.65). However, after applying IPTW, there was insufficient evidence for a difference in mortality in the full cohort (hazard ratio (HR) 1.13; 95% CI 0.93, 1.34) or among ART-naïve participants (HR 1.23; 95% CI 0.71, 2.12). Starting RAL was associated with higher HIV viral load, hepatitis C positive status (aOR 2.07; 95% CI 1.82, 2.37), prevalent end-stage renal disease (aOR 2.58; 95% CI 1.58, 4.19), chemotherapy near baseline (aOR 1.58; 1.01, 2.48), and cardiovascular disease (aOR 1.58; 95% CI 1.30, 1.91). Interpretation:In this large and well-characterised cohort we found no evidence of an association between all-cause mortality and use of RAL compared to other INSTIs after accounting for confounding at the time of starting the INSTI. Our findings suggest that prior reports of such an association could have been confounded by indication and channelling bias. While a large number of potential confounders were accounted for, the results presented are an estimation of average treatment effect using IPTW which is still vulnerable to uncontrolled confounding. Funding:CHU St Pierre Brussels HIV Cohort, Austrian HIV Cohort Study, Australian HIV Observational Database, AIDS Therapy Evaluation in the Netherlands National Observational HIV cohort, EuroSIDA cohort, Frankfurt HIV Cohort Study, Georgian National AIDS Health Information System, Nice HIV Cohort, ICONA Foundation, Modena HIV Cohort, PISCIS Cohort Study, Swiss HIV Cohort Study, Swedish InfCare HIV Cohort, Royal Free HIV Cohort Study, San Raffaele Scientific Institute, University Hospital Bonn HIV Cohort, University of Cologne HIV Cohort, Brighton HIV Cohort, and the National Croatian HIV cohort, ViiV Healthcare, Merck Life Sciences, Gilead Sciences, and the Centre of Excellence for Health, Immunity Infections (CHIP).

Castleman disease (CD) describes a group of rare lymphoproliferative disorders that exhibit a wide range of symptomatology and degree of lymphadenopathy, particularly across the two forms of CD with unknown etiology, unicentric CD (UCD) and HHV-8-negative/idiopathic multicentric CD (iMCD). Whereas UCD cases typically present with localized lymphadenopathy and mild symptoms, iMCD involves multicentric lymphadenopathy and cytokine-storm driven symptoms with three recognized clinical phenotypes. Increasingly, there are anecdotal reports of cases that do not fit into this framework, but these cases have not been systematically described. Herein, we utilize the ACCELERATE natural history registry to characterize the spectrum of CD based on disease features, symptomatology, and severity. Our results characterize a cohort of 179 CD cases, which were reviewed and confirmed by an expert panel of clinicians and hematopathologists. We show that CD patients present on a continuous spectrum of clinical phenotypes, and we describe oligocentric CD (OligoCD), an intermediate phenotype that does not fit the criteria for UCD or iMCD. These cases tend to have "oligocentric" lymphadenopathy (median [interquartile range] regions of lymphadenopathy: 3.0 [2.0,4.0]) in a regional pattern and exhibit a mild clinical phenotype that is more similar to UCD than iMCD. We also show that OligoCD patients are inconsistently categorized as UCD versus iMCD, highlighting the need for this characterization. Future data collected through ACCELERATE may further elucidate the natural history and risk profile of these patients.

Castleman disease (CD) encompasses a spectrum of rare disorders, including unicentric (UCD), idiopathic multicentric (iMCD), and human herpesvirus 8-associated MCD (HHV8+MCD). We performed a systematic review of publications reporting ≥5 cases of CD between 1995 and 2021, following PRISMA guidelines, to describe and compare subtypes. We extracted data on clinical symptoms and laboratory parameters as stated in international consensus diagnostic criteria for iMCD, and estimated the frequency of each criterion using meta-analyses. We analyzed 32 studies describing 559 UCD, 1023 iMCD, and 416 HHV8+MCD cases. Though many symptoms and laboratory abnormalities occurred at similar rates in patients with iMCD and HHV8+MCD, patients with HHV8+MCD had significantly higher rates of constitutional symptoms (46.6% vs 98.6%, p=0.038) and splenomegaly (48.2% vs 89.2%, p=0.031). Renal dysfunction was significantly more common in patients with iMCD than patients with HHV8+MCD before adjustment (36.9% vs 17.4%, p=0.04, adjusted p=0.1). Patients with UCD had lower rates of symptoms and laboratory abnormalities, though these were present in 20% of patients and were particularly pronounced in pediatric UCD. There are many similarities in the symptomatology of iMCD and HHV8+MCD; many patients experience constitutional symptoms and organ dysfunction. Differences between these subtypes likely reflect differences in pathophysiology and/or comorbidity burdens.

PURPOSE:Doxycycline post-exposure prophylaxis (Doxy-PEP) reduces the likelihood of Chlamydia and early syphilis by approximately two-thirds. Currently, data on the frequency of Doxy-PEP use in men who have sex with men (MSM) are limited. This study aimed to assess knowledge, attitude towards, and frequency of Doxy-PEP use among MSM in Germany. METHODS:We conducted a national online survey in Germany from summer to fall 2023, recruiting MSM and transgender women. Participants were invited to complete the online survey through social media, online dating platforms, and print media advertisements with active recruitment and poster advertising in private practices, tertiary outpatient clinics, and MSM community events in Germany. RESULTS:In total, 438 participants completed the survey and were included in the analysis, and 285 (65.1%) were living with the human immunodeficiency virus (HIV) or taking HIV-pre-exposure prophylaxis (PrEP). Overall, 170 participants (38.8%) had heard of Doxy-PEP, and 275 (62.8%) would consider taking it, but only 32 (7.3%) reported having ever taken Doxy-PEP. The most common reason for a negative attitude towards Doxy-PEP were apprehension about insufficient detailed information, and concerns about antibiotic resistance. Doxy-PEP users were more likely to be on HIV-PrEP, had a higher self-reported risk of bacterial sexually transmitted infections (STIs), and often had a history of bacterial STIs. CONCLUSION:The study demonstrated high awareness and strong interest in Doxy-PEP among MSM in Germany, most of whom were living with HIV or taking HIV-PrEP; however, the actual usage of Doxy-PEP remains low in the summer and fall of 2023.

Cryptococcosis is the most prevalent fungal infection of the central nervous system worldwide. We performed a retrospective multicenter cohort study to gain insights into the epidemiology of cryptococcosis in Germany. We describe the use of diagnostic tests, clinical management and patient outcome. We included 64 patients with underlying HIV infection (55%) or other predispositions. Molecular typing by MLST documented 20 individual sequence types among 42 typed isolates. A fatal outcome was documented in 14% of patients in the first two months after diagnosis.

HIV MedicineEarly View LETTER TO THE EDITOR Immunological alterations with GLP-1 agonists in people living with HIV Sebastian Noe, Corresponding Author Sebastian Noe [email protected] MVZ München am Goetheplatz, Munich, Germany Correspondence Sebastian Noe, MVZ München am Goetheplatz, Munich, Germany. Email: [email protected]Search for more papers by this authorAnna Ivanova, Anna Ivanova UHasselt, Data Science Institute, Hassel, BelgiumSearch for more papers by this authorCelia Johnsson-Oldenbüttel, Celia Johnsson-Oldenbüttel MVZ München am Goetheplatz, Munich, GermanySearch for more papers by this authorGuido Schäfer, Guido Schäfer ICH Study Center, Hamburg, GermanySearch for more papers by this authorKnud Schewe, Knud Schewe ICH Study Center, Hamburg, GermanySearch for more papers by this authorChristian Hoffmann, Christian Hoffmann orcid.org/0000-0002-1082-8093 ICH Study Center, Hamburg, Germany University Hospital of Schleswig Holstein, Campus Kiel, GermanySearch for more papers by this author Sebastian Noe, Corresponding Author Sebastian Noe [email protected] MVZ München am Goetheplatz, Munich, Germany Correspondence Sebastian Noe, MVZ München am Goetheplatz, Munich, Germany. Email: [email protected]Search for more papers by this authorAnna Ivanova, Anna Ivanova UHasselt, Data Science Institute, Hassel, BelgiumSearch for more papers by this authorCelia Johnsson-Oldenbüttel, Celia Johnsson-Oldenbüttel MVZ München am Goetheplatz, Munich, GermanySearch for more papers by this authorGuido Schäfer, Guido Schäfer ICH Study Center, Hamburg, GermanySearch for more papers by this authorKnud Schewe, Knud Schewe ICH Study Center, Hamburg, GermanySearch for more papers by this authorChristian Hoffmann, Christian Hoffmann orcid.org/0000-0002-1082-8093 ICH Study Center, Hamburg, Germany University Hospital of Schleswig Holstein, Campus Kiel, GermanySearch for more papers by this author First published: 03 March 2024 https://doi.org/10.1111/hiv.13631Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. REFERENCES 1Zino L, Tack CJ, Richel O, Burger DM. GLP-1 agonists for people living with HIV and obesity, is there potential? HIV Med. 2023; 24: 1029-1034. 10.1111/hiv.13521 CASPubMedWeb of Science®Google Scholar 2Aso Y, Fukushima M, Sagara M, et al. Sitagliptin, a DPP-4 inhibitor, alters the subsets of circulating CD4+ T cells in patients with type 2 diabetes. Diabetes Res Clin Pract. 2015; 110: 250-256. 10.1016/j.diabres.2015.10.012 CASPubMedWeb of Science®Google Scholar 3Liberman A, Esser M, Marx N, Burgmaier M. Glucagon-like Peptide-1(9-36) inhibits chemokine-induced migration of human CD4-positive lymphocytes. PloS One. 2013; 8:e58445. 10.1371/journal.pone.0058445 CASPubMedWeb of Science®Google Scholar 4Rode AKO, Buus TB, Mraz V, et al. Induced human regulatory T cells express the glucagon-like Peptide-1 receptor. Cells. 2022; 11: 2587. 10.3390/cells11162587 CASPubMedWeb of Science®Google Scholar Early ViewOnline Version of Record before inclusion in an issue ReferencesRelatedInformation

Results of a prospective study of stage-adapted treatment of human immunodeficiency virus (HIV)-associated Hodgkin lymphoma (HIV-HL) showed a 2-year overall survival (OS) of 90.7% with no significant difference between early favorable (EF), early unfavorable (EU), and advanced HL. Patients with EF HIV-HL received two to four cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) + 30 Gy involved field (IF) radiation, those with EU HIV-HL received four cycles of ABVD or BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) baseline + 30 Gy IF, and six to eight cycles of BEACOPP baseline were administered in advanced disease. The objective of the present analysis is to determine long-term outcomes of HIV-HL. Of 108 patients, 23 (21%) had EF HL, 14 (13%) had EU HL, and 71 (66%) had advanced-stage HL. After a median follow-up of 9.14 (range, 0–12.9) years, there were five primary refractory HL patients (5%) and 11 relapses (10%), of which seven were late relapses (>2 years). A second primary malignancy (SPM) occurred in 10 patients after a median of 7.3 years (range, 1.5–10.7) from HL diagnosis. The 10-year OS for patients with EF, EU, and advanced HL was 95.7%, 84.6%, and 76.1%, respectively. By multivariate analysis, Center for Disease Control and Prevention category C (hazard ratio [HR] 3.00, 95% confidence interval [CI]: 1.16–7.74, p  = 0.023) and achievement of complete remission were significant for OS (HR 0.03, 95% CI: 0.01–0.08, p  = 2.45 × 10 −9 ). In conclusion, a stage-adapted treatment approach for HIV-HL is highly effective with long-term survival rates similar to those reported in HIV-uninfected HL. However, the risk for late relapse and SPM is significant.

This EHA-ESMO Clinical Practice Guideline provides key recommendations for managing HIV-associated lymphomas.The guideline covers clinical, imaging and pathological diagnosis; staging and risk assessment; treatment and follow-up.The author group encompasses a multidisciplinary group of experts from different institutions and countries in Europe.Recommendations are based on available scientific data and the authors' collective expert opinion.