Hepatocellular carcinoma in HIV-infected patients: Epidemiological features, clinical presentation and outcome

Massimo Puoti, Raffaele Bruno, Vincent Soriano, Francesco Donato, Giovanni Battista Gaeta, Gian Paolo Quinzan, Davide Precone, Umberto Gelatti, Victor Asensi, Emanuela Vaccher

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Hepatocellular carcinoma (HCC) is an increasing cause of mortality in HIV-seropositive individuals. The aim of the study was to compare the main features of HCC in HIV-seropositive individuals with those in to HIV-negative patients. Patients and methods: All HIV-infected subjects with a diagnosis of HCC included in three cancer registry databases were enrolled in the study as cases. HCC cases that occurred in the province of Brescia, North Italy, in the period 1995-1998 and all cases reported at the Italian Liver Cancer Project were enrolled as controls. All data were collected using a standardized case report form. The main clinical and epidemiological characteristics of patients with HCC and their survival were compared between HIV-positive and uninfected subjects. Results: Forty-one HIV-infected subjects with HCC were identified. Multivariate analysis adjusted for age and sex identified an association between HIV infection and HCV infection [odds ratio (OR), 11; P = 0.005], and infiltrating tumours and/or extranodal metastasis at presentation (OR = 11.8; P <0.001). HIV infection was independently associated with shorter survival (hazard ratio, 1.63; P = 0.015). Conclusions: HCC in HIV-infected patients is mainly associated with underlying chronic hepatitis C and has a more aggressive clinical course. Thus, preventative strategies (including the treatment of hepatitis C) should be implemented in the management of HIV/HCV-coinfected patients.

Original languageEnglish
Pages (from-to)2285-2293
Number of pages9
JournalAIDS (London, England)
Volume18
Issue number17
DOIs
Publication statusPublished - Nov 19 2004

Keywords

  • Alcohol
  • Cirrhosis
  • Hepatitis B
  • Hepatitis C
  • Hepatocellular carcinoma
  • HIV

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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