We recommend that fit patients with relapsed/refractory HL should receive salvage chemotherapy and, if the disease proves to be chemosensitive, consolidate the response with HDT/ASCR (level of evidence 1B). While there

is no direct evidence to support opportunistic prophylaxis specifically in HL, buy Talazoparib prophylaxis is nevertheless recommended for PCP, MAI and fungal infections as in other HIV-related lymphomas [61]. We recommend PCP, MAI and fungal infection prophylaxis (level of evidence 1D). No specific response criteria for HL in patients living with HIV have been described, so the response criteria defined for the general population should be used [62,63]. These guidelines were initially developed for patients with non-Hodgkin lymphoma (NHL) and were subsequently reviewed and modified to include HL, amongst other modifications.

One of the important modifications is the recommendation for FDG-PET scanning both at baseline and for the assessment of response signaling pathway in HL. Interpretation of FDG-PET in patients with HIV infection should be made with caution as increased FDG uptake is detected in those with unsuppressed HIV viral loads [64,65]. However, in the absence of specific data on the applicability of FDG-PET scanning in HIV-positive patients with HL, the same investigations and response criteria used in HIV-negative patients should be followed. Thus, assessment after treatment should include an FDG-PET scan and a BM biopsy

if the BM was involved at diagnosis. These investigations should be performed at least 4–6 weeks after the last cycle of chemotherapy. Regarding follow-up, several (empirically defined) schedules have been recommended for patients in CR, from 2 to 4 months for the first 2 years and from 3 to 6 months for the subsequent 3 years [33,66]. Investigations at follow-up should include medical history, physical examination and blood tests. No further surveillance investigations Alanine-glyoxylate transaminase are recommended for patients in CR [67]. Patients who have received RT should have thyroid function tests checked regularly and female patients treated with Mantle RT should have surveillance mammography [33,66]. We recommend assessment of response after treatment should be performed by FDG-PET scan and BM biopsy (level of evidence 1D). We recommend assessment during follow-up should be performed every 2–4 months during the first 2 years and every 3–6 months for 3 further years (level of evidence 1D). People living with HIV and Hodgkin lymphoma who require blood products should receive irradiated products in line with the national guidelines, as should patients who are candidates for stem-cell transplantation (GPP). 1 Grulich A, Li Y, McDonald A et al. Rates of non-AIDS defining cancers in people with HIV infection before and after AIDS diagnosis. AIDS 2002; 16: 1155–1161. 2 Burgi A, Brodine S, Wegner S et al.