Viral co-infections, such as Epstein-Barr virus (EBV), Human Herpesvirus-8 (HHV-8), and Human Papillomavirus (HPV), contribute significantly to the development of HIV-associated malignancies. This section discusses the viraldriven oncogenic pathways and their interactions with HIV in promoting tumour development. Persistent immune activation and chronic inflammation in PLWH create a tumour-promoting microenvironment. The dysregulation of cytokines, chemokines, and growth factors contributes to tumour initiation, progression, and immune evasion. This section explores the role of chronic inflammation in HIV-associated malignancies [3-5].