Long-Acting Albuvirtide Combined with Intensive Immunochemotherapy for HIV-associated Diffuse Large B-Cell Lymphoma: A Retrospective Study

Abstract Background This retrospective study evaluated albuvirtide (ABT)-based combination antiretroviral therapy (cART) during intensive immunochemotherapy in HIV-associated DLBCL. Methods In this single-center retrospective study, 80 ABT-treated patients from 2023–2024 were screened; 54 were included, comprising 33 patients with HIV RNA > 50 copies/mL and 21 patients with HIV RNA ≤ 50 copies/mL. Endpoints included HIV-1 RNA change, virological suppression, CD4 + T-cell counts, CD4/CD8 ratio, tumor-marker expression, and control-trained 12-week landmark Cox survival prediction. Results In HIV RNA > 50 copies/mL subgroup, median HIV-1 RNA decreased by 3.14 log 10 copies/mL by Week 12 (p < 0.001), and 85.71% achieved virological suppression. Median CD4 + counts increased by 36 cells/µL at Week 8 and 30 cells/µL at Week 12; CD4/CD8 ratio improved from 0.17 to 0.34 (p < 0.001). The Cox model included 49 non-ABT patients (25 deaths) and showed modest discrimination (C-index = 0.611); predicted ABT OS probabilities were 0.609, 0.544, and 0.383 at 6, 12, and 24 months. For patients with HIV RNA ≤ 50 copies/mL, 12-week ABT therapy sustained virological suppression with improved systemic immunity. Conclusions ABT-based long-acting cART was associated with rapid virological suppression in patients with HIV RNA > 50 copies/mL and exploratory immune and tumor-marker improvements. Survival predictions were hypothesis-generating only.