Uusküla Anneli, Tisler Anna, DeHovitz Jack, Murenzi Gad, Castle Philip E, Clifford Gary
Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia.
Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia.
Lancet HIV. 2025 Apr;12(4):e293-e302. doi: 10.1016/S2352-3018(25)00011-6. Epub 2025 Mar 11.
The advent of effective antiretroviral therapy (ART) has increased the lifespan of many people living with HIV. As a result, cancers driven by high-risk human papillomavirus (HPV) infection have emerged as an increasingly important cause of mortality in this population. The complex interplay between HIV and HPV necessitates a deep understanding of the HPV-related cancer burden in people living with HIV and the integration of effective prevention strategies into their care. Although cervical cancer is a global concern, anal cancer is more important among people living with HIV in settings where HIV is more concentrated among men who have sex with men. High HPV prevalence, coupled with resource constraints, particularly in sub-Saharan Africa, where the majority of people living with HIV reside, creates substantial barriers to successful prevention and management of HPV-related malignancies. Implementing preventive measures, such as HPV vaccination and comprehensive screening programmes, is crucial and will require addressing existing health inequities and developing tailored interventions for people living with HIV. The development of enhanced secondary prevention tools and innovative treatment modalities is essential to mitigate the burden of HPV-associated cancers and improve the overall health outcomes for this vulnerable population.
有效的抗逆转录病毒疗法（ART）的出现延长了许多艾滋病毒感染者的寿命。因此，由高危型人乳头瘤病毒（HPV）感染引发的癌症已成为该人群中日益重要的死亡原因。艾滋病毒与HPV之间复杂的相互作用，使得深入了解艾滋病毒感染者中与HPV相关的癌症负担，并将有效的预防策略纳入其护理工作变得十分必要。虽然宫颈癌是一个全球关注的问题，但在艾滋病毒在男男性行为者中更为集中的地区，肛门癌在艾滋病毒感染者中更为重要。HPV的高流行率，再加上资源限制，特别是在撒哈拉以南非洲地区（大多数艾滋病毒感染者居住在此），为成功预防和管理与HPV相关的恶性肿瘤造成了巨大障碍。实施预防措施，如HPV疫苗接种和全面筛查计划，至关重要，这将需要解决现有的健康不平等问题，并为艾滋病毒感染者制定量身定制的干预措施。开发强化的二级预防工具和创新的治疗方式对于减轻HPV相关癌症的负担以及改善这一弱势群体的整体健康状况至关重要。
