Cirrhosis and hepatocellular carcinoma in patients with HIV

A study in this month's issue of Hepatology examines the prevalence of cirrhosis and hepatocellular carcinoma in patients with human immunodeficiency virus infection.

Cirrhosis is a leading cause of death among patients infected with human immunodeficiency virus.

Dr Geaorge Ioannou and colleagues determined risk factors for and time trends in the prevalence of cirrhosis, decompensated cirrhosis, and hepatocellular carcinoma among patients diagnosed with HIV who received care in the Veterans Affairs health care system nationally between 1996 and 2009.

The team noted that among patients coinfected with HIV and hepatitis C virus, there was a dramatic increase in the prevalence of cirrhosis, decompensated cirrhosis, and hepatocellular carcinoma.

Little increase was observed among patients without hepatitis C virus coinfection in the prevalence of cirrhosis, decompensated cirrhosis, and hepatocellular carcinoma.

The doctors assessed that in 2009, hepatitis C virus infection infection was present in the majority of patients with human immunodeficiency virus who had cirrhosis, decompensated cirrhosis, and hepatocellular carcinoma.

Independent risk factors for cirrhosis included hepatitis C virus infection, hepatitis B virus infection, age, Hispanic ethnicity, diabetes, and alcohol abuse, whereas black race and successful eradication of hepatitis C virus were protective.

165 achieved sustained virologic response

Hepatology

The research team reported that independent risk factors for hepatocellular carcinoma included hepatitis C virus infection, hepatitis B virus infection, age, and low CD4+ cell count.

Among 5999 human immunodeficiency virus /hepatitis C virus-coinfected patients, 994 had ever received hepatitis C virus infection antiviral treatment, of whom 165 achieved sustained virologic response.

Dr George's team concluded, "The prevalence of cirrhosis and hepatocellular carcinoma has increased dramatically among HIV-infected patients driven primarily by the hepatitis C virus epidemic."

"Potentially modifiable risk factors include hepatitis C virus infection, hepatitis B virus infection, diabetes, alcohol abuse, and low CD4+ cell count."