Impact of HIV on the survival of hepatocellular carcinoma in hepatitis C virus-infected patients

Autor: Merchante N, Rodriguez-Fernandez M, Figueruela B, Rodriguez-Arrondo F, Revollo B, Ibarra S, Tellez F, Merino E, Montero-Alonso M, Galindo M, Rivero-Juarez A, de Los Santos I, Delgado-Fernandez M, Garcia-Deltoro M, Vera-Mendez F, Garcia M, Aguirrebengoa K, Portu J, Rios-Villegas M, Villalobos M, Aleman-Valls M, Minguez C, Galera C, Macias J, Pineda J, GEHEP-002 Study Grp
Rok vydání: 2020
Předmět:
Zdroj: AIDS
r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
instname
AIDS (London, England)
r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
ISSN: 0269-9370
Popis: 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 alpha-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.
Databáze: OpenAIRE
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