Epidemiological Profile and Clinical Outcomes of HIV-Associated Malignancies in Georgia: A Five-Year Retrospective Study

Abstract

Background: HIV-associated malignancies remain a significant clinical and public health burden globally. Although antiretroviral therapy (ART) has reduced the incidence of AIDS-defining cancers (ADCs), non-AIDS-defining cancers (NADCs) now constitute a growing proportion of cancers among people living with HIV (PLWH)^.

Methods: To characterize the epidemiology, cancer spectrum, immunologic profiles, and mortality outcomes of malignancies among PLWH in Georgia over a five-year period Methods: A retrospective analysis of 1,945 newly registered PLWH between 2020 and 2025 was conducted at the T. Tsertsvadze Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia (18). Demographic variables, cancer types, CD4 cell counts, ART status, and mortality were evaluated.

Results:A total of 44 malignancy cases (2.26%) were identified. ADCs accounted for 18 cases (41%), while NADCs comprised 26 cases (59%). The median CD4 cell count was significantly lower among patients with ADCs (158 cells/mm³) compared with those with NADCs (354 cells/mm³)(15,6). The overall mortality rate was 31.8%, with the highest mortality observed in patients with ADCs (37.5%) and in those with CD4 counts <200 cells/mm³ (50%) (10,3). .

Conclusions: The shift toward NADCs, substantial mortality, and strong association between CD4 count and malignancy underscore the urgent need for earlier HIV diagnosis , integrated HIV–oncology care, and implementation of structured cancer screening strategies for PLWH in Georgia (14,16,20).