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Hepatocellular carcinoma in 40 HIV/HCV-coinfected versus 50 HCV-monoinfected patients. North American HCC in HIV Study Group
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Reported by Jules Levin
IAS-Rio July 2005
TuPe1.1C17
Authors conclusion: HIV/HCV-coinfected patients develop HCC at a younger age than HCV-monoinfected patients due to a shorter interval from HCV infection to HCC (35 vs 26 years). In contrast to the European study, we did not find a difference in survival between HIV/HCV and HCV patients.
Bräu N.1, Xiao P.2, Naqvi Z.3, Taylor L.E.4, Sulkowski M.S.5, Sherman M.6, Trikha A.1, Rigsby M.O.7, Martyn C.3, Dieterich D.T.8, Wright T.L.9, Brown S.
T.1, Bini E.J.10
1Veterans Affairs Medical Center, Bronx, NY and Mount Sinai School of Medicine, New York, NY, United States of America, 2NYU Downtown Hospital,
New York, NY, United States of America, 3Veterans Affairs Medical Center, Bronx, NY, United States of America, 4The Miriam Hospital, Providence, RI,
United States of America, 5Johns Hopkins Medical Institute, Baltimore, Maryland, United States of America, 6Toronto General Hospital, Toronto, ON,
Canada, 7VA Connecticut Health Care System, West Haven, CT, United States of America, 8Mount Sinai Medical Center, New York, NY, United States
of America, 9Veterans Affairs Medical Center, San Francisco, CA, United States of America, 10VA New York Harbor HCS, New York, NY, United States
of America
ABSTRACT
Introduction: As HIV-infected patients live longer through HAART, they suffer the consequences of coinfection with the hepatitis C virus (HCV). Few data are available on hepatocellular carcinoma (HCC) in HIV-infected persons. One recent Italian-Spanish study showed that survival of HCC is shorter in HIV-positive than in HIV-negative patients.
Methods: A retrospective chart review in 14 US and Canadian medical centers identified 40 HIV/HCV-coinfected patients with HCC. They were compared to 50 HCV-monoinfected control patients.
Results: See table for details. Only 1 of 90 patients was female. HIV/HCV patients were younger than HCV patients, and they consumed less alcohol.
Time from initial HCV infection to HCC was 7.5 years shorter in HIV/HCV compared to HCV patients (26.4 yrs, n=30, vs 35.2 yrs, n=62).
HIV/HCV patients had more frequently extrahepatic metastases than HCV patients, but the rate of portal vein thrombosis was the same (7.5% vs. 2.0%). Median survival was similar in both groups.
Both groups were similar in median AFP levels (1,470 vs. 730 ng/ml) and other laboratory values.
There was also no difference in mean Child-Turcotte- Pugh (CTP) scores (7.5 vs. 7.6),
Cancer of the Liver Italian Project (CLIP) tumor staging scores (3.0 vs. 2.7), and frequencies of receiving any HCC therapy (56% vs. 36%, p=0.025).
Conclusions: HIV/HCV-coinfected patients develop HCC at a younger age than HCV-monoinfected patients due to a shorter interval from HCV infection to HCC. In contrast to the European study, we did not find a difference in survival between HIV/HCV and HCV patients.
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