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People living with HIV are up to 17 times more likely to develop NHL, and as such, DLBCL is the leading cause of cancer death in this high\u2010risk population. While histologically indistinguishable, HIV\u2010associated (HIV+) and HIV\u2010negative (HIV\u2212) DLBCL are molecularly distinct, and biological differences may have implications for the development of future therapeutic interventions. Further, the impact of immunologic differences in people with HIV, including preceding ART, remains largely unknown. Here, we investigate the impact of HIV infection and ART exposure on the clinical features of DLBCL and T\u2010cell immune response by performing imaging mass cytometry on our unique patient cohort in Malawi. In this cohort, HIV infection is positively prognostic, and HIV+\/ART\u2010na\u00efve patients have the best outcomes. No established biomarkers other than Ki67 are associated with HIV or ART status, and the only tumour\u2010intrinsic biomarkers that remain prognostic are MYC and MYC\/BCL2 protein co\u2010expression. Finally, TCR clonality is associated with distinct tumour\u2010T cell interactions by HIV\/ART status, indicating differential anti\u2010tumour immune responses. We demonstrate previously undescribed HIV and ART\u2010related differences in the DLBCL tumour microenvironment.<\/jats:p>","DOI":"10.1111\/bjh.19531","type":"journal-article","created":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T21:10:10Z","timestamp":1716239410000},"page":"194-206","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["<scp>HIV<\/scp> and prior exposure to antiretroviral therapy alter tumour composition and tumour: T\u2010cell associations in diffuse large B\u2010cell lymphoma"],"prefix":"10.1111","volume":"205","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9155-4174","authenticated-orcid":false,"given":"Jenny","family":"Coelho","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, School of Medicine University of North Carolina (UNC)  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia 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