Key oncogenic and immune-metabolic signaling pathways, including HIF-1 (hsa04066), AGE-RAGE in diabetic complications (hsa04933), and PI3K-Akt (hsa04151), highlight the complex interplay between hypoxia, oxidative stress, and chronic immune activation that HIV exploits to establish persistence and drive non-AIDS comorbidities such as metabolic syndrome and cancer [58]. This evidence concerns the gene HIF1A and metabolic syndrome.