immunodeficiencyassociated

Immunodeficiency-associated refers to diseases that occur in the setting of compromised immune function. It is most commonly used to describe certain malignancies and opportunistic infections that arise when the body's immune surveillance is weakened, such as in HIV infection, congenital immunodeficiencies, or iatrogenic immunosuppression from organ transplantation or cancer therapy.

Common immunodeficiency-associated cancers include lymphomas (notably certain non-Hodgkin lymphomas), Kaposi sarcoma, and post-transplant lymphoproliferative disorders, with increased risk for virus-associated tumors linked to EBV, HHV-8, and HPV. The mechanism is reduced immune surveillance allowing oncogenic viruses to drive cell proliferation.

Diagnosis involves assessing immune status alongside standard cancer workup. Tests may include HIV testing and CD4 counts, lymphocyte subsets, immunoglobulin levels, and evaluation for opportunistic infections, plus histopathology and imaging for cancer.

Management centers on treating the underlying immunodeficiency when possible—for example initiating combination antiretroviral therapy in HIV, reducing or changing immunosuppressive drugs after transplantation, or modifying chemotherapy—and on cancer-directed therapy adapted to the patient’s immune function, with infection prophylaxis and supportive care as needed. PTLD may respond to rituximab without full chemotherapy in some cases; EBV-related tumors may require antiviral strategies though evidence is limited.

Prognosis varies by the specific disease and degree of immune dysfunction; historically, immunodeficiency-associated cancers have poorer outcomes than immunocompetent counterparts, though effective control of the underlying immunodeficiency improves prognosis in many cases.