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 20 November 2017

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News

Predictors of hepatocellular carcinoma survival in HIV

September's issue of the Journal of Hepatology reports on the presentation and outcome of hepatocellular carcinoma in HIV-infected patients.

News image

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HIV-infected patients now live longer and often have complications of liver disease, especially with Hepatitis B or C virus coinfection.

Limited data are available on those with hepatocellular carcinoma.

Dr Norbert Bräu and colleagues from New York, USA conducted a retrospective analysis from 1992 to 2005 in 6 centers identifying 63 HIV-infected hepatocellular carcinoma patients.

Controls were 226 consecutive HIV-negative hepatocellular carcinoma patients from 4 sites.

The researchers noted that HIV-positive patients were younger than controls, and more commonly had chronic Hepatitis B or C.

Platelet counts of 100,000/mm3 predicted survival
Journal of Hepatology

HIV-positive patients were more frequently symptomatic, and had a higher median alfa-fetoprotein level.

However, the team found that HIV-positive patients had a similar mean Child-Turcotte-Pugh score, and hepatocellular carcinoma staging score.

The researchers observed that hepatocellular carcinoma developed faster in HIV/Hepatitis C virus-coinfected than in Hepatitis C virus-monoinfected patients.

HIV-positive patients received proven therapy more often, but median survival was similar.

The research team found that independent factors predicting survival were symptomatic presentation, any proven therapy, and diagnosis after 2001.

Barcelona-Clínic-Liver-Cancer stages C and D, and an aspartate aminotransferase/alanine aminotransferase ratio of 2.00 predicted survival.

In addition, the researchers identified an alfa-fetoprotein level of 400 ng/mL as an independent predictor of survival.

The team noted that platelet counts of 100,000/mm3, but not HIV-serostatus predicted survival.

The team report that in HIV-infected patients without hepatocellular carcinoma therapy, median survival was longer with undetectable HIV RNA than with HIV viremia.

Dr Bräu's team concluded, "HIV-positive hepatocellular carcinoma patients are younger and more frequently symptomatic and infected with Hepatitis C or Hepatitis B virus than HIV-negative patients."

"Tumor staging and survival are similar."

"In untreated patients, undetectable HIV RNA independently predicts better survival."

J Hepatol 2007: 47(4): 527-37
12 September 2007

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