Trends in Incidences and Risk Factors for Hepatocellular Carcinoma and Other Liver Events in HIV and Hepatitis C Virus-coinfected Individuals From 2001 to 2014: A Multicohort Study

Lars I. Gjærde, Leah Shepherd, Elzbieta Jablonowska, Adriano Lazzarin, Mathieu Rougemont, Katharine Darling, Manuel Battegay, Dominique Braun, Valerie Martel-Laferriere, Jens D. Lundgren, Jürgen K Rockstroh, John Gill, Andri Rauch, Amanda Mocroft, Marina B. Klein, Lars Peters, Mauro Zaccarelli, Andrea Antinori, Rosa Antonietta Acinapura, Maria Maddalena Plazzi

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Abstract

BACKGROUND: While liver-related deaths in human immunodeficiency virus (HIV) and hepatitis C virus (HCV)-coinfected individuals have declined over the last decade, hepatocellular carcinoma (HCC) may have increased. We describe the epidemiology of HCC and other liver events in a multicohort collaboration of HIV/HCV-coinfected individuals.

METHODS: We studied HCV antibody-positive adults with HIV in the EuroSIDA study, the Southern Alberta Clinic Cohort, the Canadian Co-infection Cohort, and the Swiss HIV Cohort study from 2001 to 2014. We calculated the incidence of HCC and other liver events (defined as liver-related deaths or decompensations, excluding HCC) and used Poisson regression to estimate incidence rate ratios.

RESULTS: Our study comprised 7229 HIV/HCV-coinfected individuals (68% male, 90% white). During follow-up, 72 cases of HCC and 375 other liver events occurred, yielding incidence rates of 1.6 (95% confidence interval [CI], 1.3, 2.0) and 8.6 (95% CI, 7.8, 9.5) cases per 1000 person-years of follow-up, respectively. The rate of HCC increased 11% per calendar year (95% CI, 4%, 19%) and decreased 4% for other liver events (95% CI, 2%, 7%), but only the latter remained statistically significant after adjustment for potential confounders. Older age, cirrhosis, and low current CD4 cell count were associated with a higher incidence of both HCC and other liver events.

CONCLUSIONS: In HIV/HCV-coinfected individuals, the crude incidence of HCC increased from 2001 to 2014, while other liver events declined. Individuals with cirrhosis or low current CD4 cell count are at highest risk of developing HCC or other liver events.

Original languageEnglish
Pages (from-to)821-9
Number of pages9
JournalClinical Infectious Diseases
Volume63
Issue number6
DOIs
Publication statusPublished - Sep 15 2016

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Gjærde, L. I., Shepherd, L., Jablonowska, E., Lazzarin, A., Rougemont, M., Darling, K., Battegay, M., Braun, D., Martel-Laferriere, V., Lundgren, J. D., Rockstroh, J. K., Gill, J., Rauch, A., Mocroft, A., Klein, M. B., Peters, L., Zaccarelli, M., Antinori, A., Acinapura, R. A., & Plazzi, M. M. (2016). Trends in Incidences and Risk Factors for Hepatocellular Carcinoma and Other Liver Events in HIV and Hepatitis C Virus-coinfected Individuals From 2001 to 2014: A Multicohort Study. Clinical Infectious Diseases, 63(6), 821-9. https://doi.org/10.1093/cid/ciw380