{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T09:08:05Z","timestamp":1789031285039,"version":"build-2803163510"},"reference-count":31,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Despite effective antiretroviral therapy, cancer remains a relevant comorbidity in people living with HIV (PLWH), with an increasing burden of non-AIDS-defining cancers (NADCs). We assessed cancer prevalence and systemic inflammation using a composite score based on routine inflammatory biomarkers. Methods: We conducted a retrospective cross-sectional study of PLWH in Ferrara, Italy. Cancer history, immunovirological parameters, IL-6, CRP, D-dimer, and monocyte counts were collected. A composite inflammatory score (0\u20134) was derived from biomarker abnormalities and compared between AIDS-defining cancers (ADCs) and NADCs. Results: Among 566 participants, 64 had a history of cancer (11.3%; 95% CI, 8.7\u201313.9%), accounting for 79 diagnoses: 23 (29.1%) ADCs and 56 (70.9%) NADCs. Most diagnoses (82.3%) were associated with inflammatory scores of 0\u20131, whereas 17.7% had scores of 2\u20134, with similar distributions between ADCs and NADCs (17.4% vs. 17.9%; p = 0.962). D-dimer elevation was more frequent among NADCs than ADCs (42.9% vs. 21.7%). Higher inflammatory scores were significantly associated with lower current CD4+ T-cell counts (p = 0.043). Conclusions: Cancer was a substantial comorbidity among PLWH, with NADCs predominating despite favorable immunovirological status. The composite score integrated routinely available inflammatory, coagulation, and immune parameters, with higher scores associated with lower CD4+ counts. Although inflammatory profiles did not differ significantly between ADCs and NADCs, this finding highlights the complexity of immune dysregulation in PLWH and the limitations of individual circulating biomarkers. Further validation of composite inflammatory scores may provide a clinically accessible framework for characterizing residual immune dysfunction and its relationship with cancer development and outcomes.<\/jats:p>","DOI":"10.3390\/cancers18182929","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T08:07:41Z","timestamp":1789027661000},"page":"2929","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cancer Burden and Inflammaging Among People Living with HIV: An Inflammatory Biomarker Analysis from an Italian Cohort"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6133-0386","authenticated-orcid":false,"given":"Daniela","family":"Segala","sequence":"first","affiliation":[{"name":"Department of Translational Medicine and for Romagna, University of Ferrara, Azienda Unit\u00e0 Sanitaria Locale di Ferrara, 44121 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1381-1394","authenticated-orcid":false,"given":"Bianca Maria","family":"Interlenghi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, 44121 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7440-6447","authenticated-orcid":false,"given":"Rosario","family":"Cultrera","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine and for Romagna, University of Ferrara, Azienda Unit\u00e0 Sanitaria Locale di Ferrara, 44121 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"ref_1","unstructured":"Joint United Nations Programme on HIV\/AIDS (UNAIDS) (2026). Global AIDS Brief\u2014United to End AIDS, UNAIDS. Available online: https:\/\/www.unaids.org\/en\/resources\/documents\/2026\/20260612_Global_AIDS_brief."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.2174\/1568026619666190712204603","article-title":"Discovery and development of anti-HIV therapeutic agents: Progress towards improved HIV medication","volume":"19","author":"Maeda","year":"2019","journal-title":"Curr. Top. Med. Chem."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1002\/ijc.35493","article-title":"Cancer incidence in people with HIV in Italy: Comparison of the ICONA COHORT with general population data","volume":"157","author":"Piselli","year":"2025","journal-title":"Int. J. Cancer"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1146\/annurev-med-042909-093756","article-title":"HIV infection, inflammation, immunosenescence, and aging","volume":"62","author":"Deeks","year":"2011","journal-title":"Annu. Rev. Med."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Isaguliants, M., Bayurova, E., Avdoshina, D., Kondrashova, A., Chiodi, F., and Palefsky, J.M. (2021). Oncogenic effects of HIV-1 proteins, mechanisms behind. Cancers, 13.","DOI":"10.3390\/cancers13020305"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1038\/nm1511","article-title":"Microbial translocation is a cause of systemic immune activation in chronic HIV infection","volume":"12","author":"Brenchley","year":"2006","journal-title":"Nat. Med."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Kuller, L.H., Tracy, R., Belloso, W., De Wit, S., Drummond, F., Lane, H.C., Ledergerber, B., Lundgren, J., Neuhaus, J., and Nixon, D. (2008). Inflammatory and coagulation biomarkers and mortality in patients with HIV infection. PLoS Med., 5.","DOI":"10.1371\/journal.pmed.0050203"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Mui, U.N., Haley, C.T., and Tyring, S.K. (2017). Viral oncology: Molecular biology and pathogenesis. J. Clin. Med., 6.","DOI":"10.3390\/jcm6120111"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Segala, D., Stancanelli, M., and Cultrera, R. (2025). Cancer prevention pathways in people living with HIV: Assessment of prevalence and related factors among individuals attending HIV Division of Ferrara Hospital. J. Pers. Med., 15.","DOI":"10.3390\/jpm15090434"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1038\/nri.2016.90","article-title":"Sex differences in immune responses","volume":"16","author":"Klein","year":"2016","journal-title":"Nat. Rev. Immunol."},{"key":"ref_11","first-page":"61","article-title":"Sex differences in HIV infection","volume":"441","author":"Altfeld","year":"2023","journal-title":"Curr. Top. Microbiol. Immunol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e2224897","DOI":"10.1001\/jamanetworkopen.2022.24897","article-title":"Cancer incidence among adults with HIV in a population-based cohort in Korea","volume":"5","author":"Park","year":"2022","journal-title":"JAMA Netw. Open"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1038\/s41574-018-0059-4","article-title":"Inflammaging: A new immune-metabolic viewpoint for age-related diseases","volume":"14","author":"Franceschi","year":"2018","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"ofab131","DOI":"10.1093\/ofid\/ofab131","article-title":"Associations between plasma human immunodeficiency virus (HIV) ribonucleic acid levels and incidence of invasive cancer in people with HIV after initiation of combination antiretroviral therapy","volume":"8","author":"Elvstam","year":"2021","journal-title":"Open Forum Infect. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1093\/infdis\/jiq118","article-title":"Plasma levels of soluble CD14 independently predict mortality in HIV infection","volume":"203","author":"Sandler","year":"2011","journal-title":"J. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1111\/hiv.70017","article-title":"Biomarkers of inflammation and coagulation predict non-AIDS-defining events in a prospective cohort of virologically suppressed people living with HIV","volume":"26","author":"Saumoy","year":"2025","journal-title":"HIV Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1097\/QAI.0000000000003667","article-title":"Markers of inflammation and immune dysfunction and non-AIDS cancer risk in adults with HIV","volume":"99","author":"Izquierdo","year":"2025","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Damane, B.P., Mulaudzi, T.V., Kader, S.S., Naidoo, P., Savkovic, S.D., Dlamini, Z., and Mkhize-Kwitshana, Z.L. (2023). Unraveling the complex interconnection between specific inflammatory signaling pathways and mechanisms involved in HIV-associated colorectal oncogenesis. Cancers, 15.","DOI":"10.3390\/cancers15030748"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1687275","DOI":"10.1080\/20013078.2019.1687275","article-title":"Extracellular vesicles and chronic inflammation during HIV infection","volume":"8","author":"Romaniuk","year":"2019","journal-title":"J. Extracell. Vesicles"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Marino, A., Pavone, G., Martorana, F., Fisicaro, V., Motta, L., Spampinato, S., Celesia, B.M., Cacopardo, B., Vigneri, P., and Nunnari, G. (2024). Navigating the nexus: HIV and breast cancer\u2014A critical review. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25063222"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"925712","DOI":"10.4061\/2011\/925712","article-title":"Breast cancer in the setting of HIV","volume":"2011","author":"Palan","year":"2011","journal-title":"Pathol. Res. Int."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1002\/ijc.33981","article-title":"Impact of HIV infection on survival among women with stage I\u2013III breast cancer: Results from the South African Breast Cancer and HIV Outcomes Study","volume":"151","author":"Ayeni","year":"2022","journal-title":"Int. J. Cancer"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2408","DOI":"10.1200\/JCO.2014.55.1341","article-title":"Oral human papillomavirus (HPV) infection in HPV-positive patients with oropharyngeal cancer and their partners","volume":"32","author":"Gross","year":"2014","journal-title":"J. Clin. Oncol."},{"key":"ref_24","first-page":"589","article-title":"HIV and inflamm-aging: How do we reach the summit of healthy aging?","volume":"32","author":"Sheets","year":"2024","journal-title":"Top. Antivir. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1016\/S1470-2045(24)00189-X","article-title":"Cancer risk in people living with HIV and solid organ transplant recipients: A systematic review and meta-analysis","volume":"25","author":"Jin","year":"2024","journal-title":"Lancet Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1093\/cid\/ciad671","article-title":"Measures of longitudinal immune dysfunction and risk of AIDS and non-AIDS defining malignancies in antiretroviral-treated people with human immunodeficiency virus","volume":"78","author":"Chammartin","year":"2024","journal-title":"Clin. Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e338","DOI":"10.1093\/cid\/ciaf248","article-title":"Risk of cancer in people with HIV experiencing varying degrees of immune recovery with sustained virological suppression on antiretroviral treatment for more than 2 years: An international, multicenter, observational cohort","volume":"81","author":"Han","year":"2025","journal-title":"Clin. Infect. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1097\/QAI.0000000000003350","article-title":"The association of HIV control and immunosuppression with risk of non-AIDS-defining cancer among patients on antiretroviral therapy","volume":"95","author":"Dickey","year":"2024","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"20590","DOI":"10.1002\/cam4.6585","article-title":"Cancer screening in people living with HIV","volume":"12","year":"2023","journal-title":"Cancer Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1002\/cncr.31838","article-title":"Cancer disparities in people with human immunodeficiency virus: A systematic review of screening for non-AIDS-defining malignancies","volume":"125","author":"Corrigan","year":"2019","journal-title":"Cancer"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1089\/heq.2020.0001","article-title":"Improving access to cancer care in the HIV population: Qualitative research to identify barriers to care","volume":"4","author":"Corrigan","year":"2020","journal-title":"Health Equity"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/18\/2929\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T08:18:52Z","timestamp":1789028332000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/18\/2929"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,10]]},"references-count":31,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["cancers18182929"],"URL":"https:\/\/doi.org\/10.3390\/cancers18182929","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,10]]}}}