title: Hepatocellular carcinoma in HIV-infected patients: epidemiological features, clinical presentation and outcome.
abstract: OBJECTIVE
  Hepatocellular carcinoma (HCC) is an increasing cause of mortality in HIV-seropositive individuals. The aim of the study was to compare the main features of HCC in HIV-seropositive individuals with those in to HIV-negative patients.
  
  
  METHODS
  All HIV-infected subjects with a diagnosis of HCC included in three cancer registry databases were enrolled in the study as cases. HCC cases that occurred in the province of Brescia, North Italy, in the period 1995-1998 and all cases reported at the Italian Liver Cancer Project were enrolled as controls. All data were collected using a standardized case report form. The main clinical and epidemiological characteristics of patients with HCC and their survival were compared between HIV-positive and uninfected subjects.
  
  
  RESULTS
  Forty-one HIV-infected subjects with HCC were identified. Multivariate analysis adjusted for age and sex identified an association between HIV infection and HCV infection [odds ratio (OR), 11; P = 0.005], and infiltrating tumours and/or extranodal metastasis at presentation (OR = 11.8; P < 0.001). HIV infection was independently associated with shorter survival (hazard ratio, 1.63; P = 0.015).
  
  
  CONCLUSIONS
  HCC in HIV-infected patients is mainly associated with underlying chronic hepatitis C and has a more aggressive clinical course. Thus, preventative strategies (including the treatment of hepatitis C) should be implemented in the management of HIV/HCV-coinfected patients.
authors.affiliation: FClinica di Malattie Infettive, Università degli Studi di Brescia-AO Spedali Civili, Brescia, Clinica di Malattie Infettive e Tropicali, Madrid, Spain. m.puoti@iol.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Puoti
authors.forename: Raffaele
authors.initials: R
authors.lastname: Bruno
authors.forename: Vincent
authors.initials: V
authors.lastname: Soriano
authors.forename: Francesco
authors.initials: F
authors.lastname: Donato
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Gaeta
authors.forename: Gian Paolo
authors.initials: GP
authors.lastname: Quinzan
authors.forename: Davide
authors.initials: D
authors.lastname: Precone
authors.forename: Umberto
authors.initials: U
authors.lastname: Gelatti
authors.forename: Victor
authors.initials: V
authors.lastname: Asensi
authors.forename: Emanuela
authors.initials: E
authors.lastname: Vaccher
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000453:epidemiology; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D006679:HIV Seropositivity / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008113:Liver Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D015995:Prevalence; D012307:Risk Factors; D016019:Survival Analysis