Impact of HIV on the survival of hepatocellular carcinoma in hepatitis C virus-infected patients. (1st August 2020)

• Record Type: Journal Article
• Authors: Merchante, Nicolás; Rodríguez-Fernández, Miguel; Figueruela, Blanca; Rodríguez-Arrondo, Francisco; Revollo, Boris; Ibarra, Sofía; Téllez, Francisco; Merino, Esperanza; Montero-Alonso, Marta; Galindo, María J.; Rivero-Juárez, Antonio; Santos, Ignacio de Los; Delgado-Fernández, Marcial; García-Deltoro, Miguel; Vera-Méndez, Francisco J.; García, María A.; Aguirrebengoa, Koldo; Portu, Joseba; Ríos-Villegas, María J.; Villalobos, Marina; Alemán-Valls, María R.; Mínguez, Carlos; Galera, Carlos; Macías, Juan; Pineda, Juan A.
• Is Part Of: AIDS. Volume 34:Number 10(2020)
• Publication Date: 2020-08-01
• Subjects: cirrhosis -- hepatitis C virus -- hepatocellular carcinoma -- HIV -- liver cancer; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome; AIDS (Disease); Periodicals; Periodicals; 616.9792005
• DOI: 10.1097/QAD.0000000000002578
• Languages: English
• ISSNs: 0269-9370

Abstract

Abstract : Background: Previous studies have suggested that hepatocellular carcinoma (HCC) has an aggressive presentation and a shorter survival in people with HIV (PWH). This could be due to later diagnosis or lower rates of HCC treatment, and not to HIV infection itself. Aim: To assess the impact of HIV on HCC survival in hepatitis C virus (HCV)-infected patients. Methods: Multicenter cohort study (1999–2018) of 342 and 135 HCC cases diagnosed in HIV/HCV-infected and HCV-monoinfected patients. Survival after HCC diagnosis and its predictors were assessed. Results: HCC was at Barcelona-Clinic Liver-Cancer (BCLC) stage 0/A in 114 (33%) HIV/HCV-coinfected and in 76 (56%) HCV-monoinfected individuals ( P < 0.001). Of them, 97 (85%) and 50 (68%) underwent curative therapies ( P = 0.001). After a median (Q1–Q3) follow-up of 11 (3–31) months, 334 (70%) patients died. Overall 1 and 3-year survival was 50 and 31% in PWH and 69 and 34% in those without HIV ( P = 0.16). Among those diagnosed at BCLC stage 0/A, 1 and 3-year survival was 94 and 66% in PWH whereas it was 90 and 54% in HIV-negative patients ( P = 0.006). Independent predictors of mortality were age, BCLC stage and α-fetoprotein levels. HIV infection was not independently associated with mortality [adjusted hazard ratio (AHR) 1.57; 95% confidence interval: 0.88–2.78; P = 0.12]. Conclusion: HIV coinfection has no impact on the survival after the diagnosis of HCC in HCV-infected patients. Although overall mortality is higher in HIV/HCV-coinfected patients, this seem to be related with lower rates of early diagnosis HCC in HIV-infected patients and not with HIV infection itself or a lower access to HCC therapy. Abstract : Supplemental Digital Content is available in the text