艾滋病相关定义和非艾滋病相关癌症（ADC/NADC）使艾滋病毒感染者（PLHIV）易患严重疾病。本多中心研究旨在调查ADC和NADC对ICU接收的PLHIV的预后影响。研究组纳入了法国12所大学附属ICU在2015年至2020年期间所有接收的PLHIV。通过logistic回归和潜在独立变量的向后消除，测量ADC和NADC对住院期间的病死率（主要研究终点）的影响。分析ADC/NADC与住院期间治疗限制决策（次要研究终点）之间的关联。比较出院时存活的患者在指数住院期间的一年病死率（探索性研究终点），以明确ADC、NADC或无癌症之间的差异。在纳入的939例PLHIV中（中位年龄52 [43-59]岁；74.4%接受合并抗逆转录病毒治疗），97例（10.3%）有活动性NADC（主要为肺和肠道肿瘤），106例（11.3%）有活动性ADC（主要为艾滋病定义的非霍奇金淋巴瘤）。初次入院是常见情况，这些亚组中的大多数入院因细菌性败血症和非感染性肿瘤相关并发症而发生。没有癌症患者的医院病死率为12.4%，ADC患者为30.2%，NADC患者为45.4%（P<0.0001）。经过重要性和脆弱性标记的调整之后，NADC（调整后的比值比[aOR]，7.00；95%置信区间[CI]，4.07-12.05）和ADC（aOR，3.11；95% CI 1.76-5.51）与住院期间死亡独立相关。没有癌症患者的TLD患病率为8.0%，ADC患者为17.9%，NADC患者为33.0%（P<0.0001）-在癌症患者中，器官功能衰竭和非肿瘤性合并症较少被考虑。在指数住院期间存活的患者中，无癌症患者的一年病死率为7.8%，ADC患者为17.0%，NADC患者为33.3%（P<0.0001）。NADC和ADC的患病率相等，成为TLD的主要依据，并且在需要接受ICU治疗的PLHIV当前人群中强烈预示住院期间死亡。© 2023. La Société de Réanimation de Langue Francaise = 法国重症监护协会（SRLF）。

Both AIDS-defining and non-AIDS-defining cancers (ADC/NADC) predispose people living with HIV (PLHIV) to critical illnesses. The objective of this multicentre study was to investigate the prognostic impact of ADC and NADC in PLHIV admitted to the intensive care unit (ICU).All PLHIV admitted over the 2015-2020 period in 12 university-affiliated ICUs in France were included in the study cohort. The effect of ADC and NADC on in-hospital mortality (primary study endpoint) was measured through logistic regression with augmented backward elimination of potential independent variables. The association between ADC/NADC and treatment limitation decision (TLD) during the ICU stay (secondary study endpoint) was analysed. One-year mortality in patients discharged alive from the index hospital admission (exploratory study endpoint) was compared between those with ADC, NADC or no cancer.Amongst the 939 included PLHIV (median age, 52 [43-59] years; combination antiretroviral therapy, 74.4%), 97 (10.3%) and 106 (11.3%) presented with an active NADC (mostly lung and intestinal neoplasms) and an active ADC (predominantly AIDS-defining non-Hodgkin lymphoma), respectively. Inaugural admissions were common. Bacterial sepsis and non-infectious neoplasm-related complications accounted for most of admissions in these subgroups. Hospital mortality was 12.4% in patients without cancer, 30.2% in ADC patients and 45.4% in NADC patients (P < 0.0001). NADC (adjusted odds ratio [aOR], 7.00; 95% confidence interval [CI], 4.07-12.05) and ADC (aOR, 3.11; 95% CI 1.76-5.51) were independently associated with in-hospital death after adjustment on severity and frailty markers. The prevalence of TLD was 8.0% in patients without cancer, 17.9% in ADC patients and 33.0% in NADC patients (P < 0.0001)-organ failures and non-neoplastic comorbidities were less often considered in patients with cancer. One-year mortality in survivors of the index hospital admission was 7.8% in patients without cancer, 17.0% in ADC patients and 33.3% in NADC patients (P < 0.0001).NADC and ADC are equally prevalent, stand as a leading argument for TLD, and strongly predict in-hospital death in the current population of PLHIV requiring ICU admission.© 2023. La Société de Réanimation de Langue Francaise = The French Society of Intensive Care (SRLF).