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               <dc:title>Integrated phenotyping of the anti-cancer immune response in HIV-associated hepatocellular carcinoma</dc:title>
               <dc:creator>Pinato, David James</dc:creator>
               <dc:creator>Kaneko, Takahiro</dc:creator>
               <dc:creator>D'Alessio, Antonio</dc:creator>
               <dc:creator>Forner, Alejandro</dc:creator>
               <dc:creator>Fessas, Petros</dc:creator>
               <dc:creator>Mínguez Rosique, Beatriz</dc:creator>
               <dc:creator>Giannini, Edoardo G.</dc:creator>
               <dc:creator>Grillo, Federica</dc:creator>
               <dc:creator>Díaz, Alba</dc:creator>
               <dc:creator>Mauri, Francesco A.</dc:creator>
               <dc:creator>Fulgenzi, Claudia A.M.</dc:creator>
               <dc:creator>Dalla Pria, Alessia</dc:creator>
               <dc:creator>Goldin, Robert D.</dc:creator>
               <dc:creator>Pieri, Giulia</dc:creator>
               <dc:creator>Toniutto, Pierluigi</dc:creator>
               <dc:creator>Avellini, Claudio</dc:creator>
               <dc:creator>Plaz Torres, Maria Corina</dc:creator>
               <dc:creator>Akarca, Ayse U.</dc:creator>
               <dc:creator>Marafioti, Teresa</dc:creator>
               <dc:creator>Bhoori, Sherrie</dc:creator>
               <dc:creator>Miró, Jose María</dc:creator>
               <dc:creator>Bower, Mark</dc:creator>
               <dc:creator>Bräu, Norbert</dc:creator>
               <dc:creator>Mazzaferro, Vincenzo</dc:creator>
               <dc:creator>Universitat Autònoma de Barcelona</dc:creator>
               <dc:subject>HCC</dc:subject>
               <dc:subject>HIV</dc:subject>
               <dc:subject>PD-L1</dc:subject>
               <dc:subject>Prognosis</dc:subject>
               <dc:description>HIV-seropositivity shortens survival in patients with hepatocellular carcinoma (HCC). Although risk factors for HCC including HCV infection can influence T cell phenotype, it is unknown whether HIV can influence functional characteristics of the T cell infiltrate. From the Liver Cancer in HIV biorepository, we derived 129 samples of transplanted (76%) or resected (20%) HCC in eight European and North American centres. We profiled intra- and peritumoural tissue to evaluate regulatory CD4+/FOXP3+ and immune-exhausted CD8+/PD1+ T cells in HIV+ (n = 66) and HIV- (n = 63) samples. We performed targeted transcriptomics and T-cell receptor sequencing in a restricted subset of samples evaluated in relationship with HIV status. We correlated immunopathologic features with patients' characteristics including markers of HIV infection. Of the 66 HIV+ patients, 83% were HCV coinfected with an undetectable HIV viral load (51%) and a median blood CD4+ cell count of 430 cells/mm 3 (range 15-908). Patients who were HIV+ were compared with HIV- controls with similar staging characteristics including Barcelona Clinic Liver Cancer (BCLC) stage A-B (86% vs. 83%, p = 0.16), &lt;3 nodules (90% vs. 83%, p = 0.3) and median alpha-foetoprotein values (10.9 vs. 12.8 ng/ml, p = 0.72). HIV+ samples had higher PD-L1 expression rates in tumour tissue (51% vs. 8% p &lt;0.0001) and displayed denser intratumoural CD4+/FOXP3+ (p &lt;0.0001), CD8+/PD1+ (p &lt;0.0001), with lower total peritumoural CD4+ (p &lt;0.0001) and higher peritumoural CD8+/PD1+ (p &lt;0.0001). Gene set analysis revealed HIV+ cases to have evidence of dysregulated adaptive and innate immunity. Tumour-infiltrating lymphocyte clonality was not influenced by HIV status. HIV-associated HCC harbours a profoundly immune-exhausted tumour microenvironment, warranting prospective testing of immunotherapy in this treatment-deprived patient population. Hepatocellular carcinoma is a non-AIDS defining malignancy characterised by poor survival. The programmed cell death (PD-1) pathway governs antiviral and anticancer immune exhaustion and is a therapeutic target in HCC. This study highlights how HIV infection is associated with significantly higher PD-L1 expression in HCC cells and in the surrounding microenvironment, leading to changes in cytotoxic and regulatory T cell function and dysregulation of proinflammatory pathways. Taken together, our results suggest dysfunctional T cell immunity as a mechanism of worse outcome in these patients and suggest clinical testing of checkpoint inhibitors in HIV-associated HCC.</dc:description>
               <dc:date>2023</dc:date>
               <dc:type>Article</dc:type>
               <dc:relation>Instituto de Salud Carlos III PI18/00542</dc:relation>
               <dc:relation>Instituto de Salud Carlos III PI18/00961</dc:relation>
               <dc:relation>Instituto de Salud Carlos III PI21/00714</dc:relation>
               <dc:relation>JHEP Reports ; Vol. 5 (march 2023)</dc:relation>
               <dc:rights>open access</dc:rights>
               <dc:rights>Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.</dc:rights>
               <dc:rights>https://creativecommons.org/licenses/by/4.0/</dc:rights>
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