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Table 1 Examples of virally associated neoplasms reported in HIV-infected individuals, response to checkpoint blockade and mechanisms of action as well as mechanisms of action

From: Remembering the forgotten child: the role of immune checkpoint inhibition in patients with human immunod eficiency virus and cancer

Cancer

Virus

Immunotherapy

Response Rate (n/total n) (X%)

Common Side Effects

Anal Cancer

Human Papilloma Virus

Nivolumab

1/2; 50% [2]

Anemia, fatigue, rash, hypothyroidism

Burkitt’s lymphoma

Epstein Barr Virus

Not reported

Not reported

Not reported

Central nervous system lymphoma

Epstein Barr Virus

Not reported

Not reported

Not reported

Cervical Cancer

Human Papilloma Virus

Not reported

Not reported

Not reported

Hodgkin disease

Epstein Barr Virus

Nivolumab

1/1; 100% [3]

Not reported

Kaposi Sarcoma

Human Herpes Virus-8

Nivolumab or pembrolizumab

6/9; 67% [4]

Fatigue, gastrointestinal discomfort, pruritis, onycholysis

Kaposi sarcoma-associated herpesvirus multicentric Castleman disease

Human Herpes Virus-8

Not reported

Not reported

Not reported

Merkel Cell Carcinoma

Merkel Cell Polyomavirus

pembrolizumab or avelumab

2/2; 100% [5, 6]

Pneumonitis

Nasopharyngeal Carcinoma

Epstein Barr Virus

Not reported

Not reported

Not reported

Penile Cancer

Human Papilloma Virus

Not reported

Not reported

Not reported

Plasmablastic lymphoma

Epstein Barr Virus

Not reported

Not reported

Not reported

Primary effusion lymphoma

Human Herpes Virus-8

Not reported

Not reported

Not reported

Vulvar Cancer

Human Papilloma Virus

Not reported

Not reported

Not reported

  1. Biologic mechanisms that are amenable to immune checkpoint blockade associated with cancers in HIV-infected patients
  2. Viral antigens presented by host cells are recognized as foreign [1]
  3. CD4+ T cells in HIV-positive patients have increased expression of the checkpoints CTLA-4 and PD-19,11
  4. The host DNA damage response is impaired in virally-mediated cancers [12]
  5. APOBEC-related mutagenesis is associated with viruses and increases neopeptide hydrophobicity/immunogenicity and correlates with higher levels of PD-L1 expression [7, 8]