Supplementary file 1_HIV-associated immune remodeling in cervical cancer: implications for immunotherapy, biomarkers, and trial design.docx

Consequently, the effects of HIV-associated immune remodeling on the cervical cancer tumor immune microenvironment, biomarker interpretation, and response to immune checkpoint inhibition remain poorly defined. In this Review, we synthesize evidence concerning chronic inflammation, T-cell dysfunction and exhaustion, impaired antigen presentation, myeloid-mediated immunosuppression, and mucosal and microbial disruption in cervical cancer among women living with HIV.

Because direct evidence in this population remains limited, we distinguish findings derived from HIV-associated cervical cancer from supporting evidence obtained in other HIV-associated malignancies, HIV-negative cervical cancer, and broader studies of HIV, HPV, and mucosal immunology. We propose a provisional inflamed, exhausted, and mucosally disrupted (IEM) framework to organize these interacting immune processes and generate hypotheses for prospective validation.