HIVreo: Recommendations on the management of people living with HIV and cancer (PLWHC).

Abstract

e23234 Background: Despite advances in the fields of infectious diseases and oncology, cancer remains the primary cause of morbidity and mortality in people living with HIV (PLWH), partly due to ongoing disparities in treatment. To address the absence of a pre-established and shared management framework for the care of PLWHC in Italy, Fondazione The Bridge and Fondazione AIOM, in partnership with SIMIT and SITA, have promoted the creation of an ad hoc network: HIVREO - HIV Related Oncology. This network comprises infectivologists, oncologists and representatives of Third Sector organisations. The overarching objective of HIVREO was to conduct knowledge surveys and formulate recommendations for the management of PLWHC. Methods: The consensus process was conducted under the supervision of an expert methodologist using an Estimate-Talk-Estimate (ETE) methodology, designed to structure a group communication process that allowed participants to brainstorm ideas, facilitate decision-making, and reach consensus.A multidisciplinary panel of 27 health professionals (HCPs) was selected on the basis of expertise. This panel included 10 medical oncologists, 15 infectivologists, 1 psychologist, and 1 patient representative. Each HCP then blindly suggested themes or clinical questions relevant to the management of PLWHC. The 19 points that emerged from this process were then harmonised and grouped into 8 macro-areas.In a preliminary meeting, the points were proposed and discussed, and agreement was reached between the facilitator's work and the experts' opinions. Subsequently, the 27 HCPs individually drafted one or more statements on each of the 19 agreed points. In a subsequent meeting, the HCPs and the facilitator reviewed, discussed and harmonised the statements, resulting in a total of 50 statements. The statements thus generated were then presented to the members of the multidisciplinary panel, who reached a consensus. Results: Fifty statements were generated and reported in the document entitled 'HIVreo: HIV-related oncology recommendations on the management of people living with HIV and cancer'. This document is divided into thematic areas and is accompanied by evidence based on both literature review and clinical practice. Conclusions: The document is an invaluable reference point for the uniform and effective provision of care for an increasingly significant sub-population, as it adopts a multidisciplinary approach and promotes personalised, evidence-based care to enhance clinical outcomes and quality of life for PLWHC.