A study carried out by experts linked to GeSIDA (AIDS Study Group of the Spanish Society of Infectious Diseases and Clinical Microbiology) has identified a series of immunological and virological alterations that could anticipate the development of cancer in people living with HIV, even a year before diagnosis. Presented in the XVI National Congress of GeSIDA, the findings of this work are very relevant because they open new avenues to improve the early detection of non-defining tumors. (NADCs) in this population through more personalized immunological monitoring.
Since the introduction of antiretroviral treatment, the life expectancy of people with HIV has increased markedly. However, an increase in cancers not directly related to AIDS has also been observed, the incidence and mortality of which continue to be higher than those of the general population. This increased risk is attributed to accelerated aging of the immune system and a reduced ability of the body to detect and eliminate tumor cells.
The work, developed by researchers from Clinical Hospital of Barcelonaanalyzed 110 people with HIV, of which 55 had been diagnosed with cancer between 2017 and 2023 and 55 acted as a control group with no history of tumor. All of them were evaluated for levels of chronic inflammation, markers of immune regulation (checkpoints) and the size of the HIV viral reservoir. For this, advanced molecular analysis techniques were used and blood samples obtained at the time of inclusion and in a subgroup of patients 12 months before the cancer diagnosis were studied.
The results showed that people with HIV who developed cancer had almost twice the amount of virus “integrated” into their cells than those without cancer. In addition, they had higher levels of various altered immune signals, indicating that their defense system was more activated and fatigued than usual. Among them were proteins that regulate the immune response, such as LAG-3, PD-1, TIM-3 and CTLA-4whose excessive activation can weaken the body’s ability to control both the virus and tumor cells. Markers of inflammation were also detected, such as CD30, CD30L, GROα y TNF-RIIwhich reflect a persistent inflammatory state in the body and are associated with an increased risk of developing cancer. Particularly relevant, these alterations were already present a year before the cancer diagnosis, suggesting their potential value as early indicators of oncological risk.
The study suggests that people with HIV who develop cancer show an altered immunological and inflammatory profile that could be detected before the clinical appearance of the tumor. However, as the authors point out, these data should be considered preliminary and confirmed with more precise statistical analyzes and in larger series of patients, before implementing it in the clinic. These results open the door to the development of immunological biomarkers in the routine follow-up of people with HIV, with the aim of promoting the early detection of non-AIDS-defining cancers and improving their prognosis.