Standardized care management ensures similar survival rates in HIV-positive and HIV-negative patients with hepatocellular carcinoma.
OBJECTIVE
It has been suggested that HIV infection has a detrimental impact on patients with hepatocellular carcinoma (HCC). The present study sought to test this hypothesis, while controlling for tumor extension and liver disease.


METHODS
A case control and a cohort approach were performed in patients with HCC managed prospectively via dedicated multidisciplinary team meeting in a single tertiary institution between 2004 and 2009.


METHODS
Of 473 consecutive treatment-naive patients with HCC, 23 were HIV-positive (HIV) and 450 were HIV-negative (HIV). HIV patients were matched 1:2 with a control group of HIV patients in terms of the etiology of HCC, the severity of liver disease, tumor extension, and year of diagnosis.


METHODS
Curative or palliative treatment of HCC.


METHODS
Eligibility for HCC treatment, the treatment actually administered, and the survival rate.


RESULTS
The HIV population was younger than the HIV population (mean age: 49 vs. 61 years, respectively; P < 0.0001). Curative treatment was recommended by the multidisciplinary team meeting and then actually performed to a similar extent in HIV patients (74% and 43%, respectively) and their matched HIV controls (74% and 56%, respectively). The HIV and their matched HIV patients did not differ significantly in terms of the 3-year survival rate [44% vs. 48%, respectively; mean (95% confidence interval) hazard ratio = 0.64 (0.3-1.3); P = 0.2]. In a cohort analysis, HIV status was not an independent predictor of survival among curatively treated patients.


CONCLUSIONS
In an equal-access unbiased environment, HIV status does not significantly influence treatment access, delivery, and outcome.
Department of Hepatobiliary Surgery, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, AP-HP, Université Paris 7, Clichy, France.
Chetana
C
Lim
Nathalie
N
Goutte
Anne
A
Gervais
Marie-Pierre
MP
Vullierme
Dominique C
DC
Valla
Françoise
F
Degos
Olivier
O
Farges
D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000401:mortality / Q000628:therapy*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005602:France; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000150:complications* / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010346:Patient Care Management / Q000592:standards; D010348:Patient Care Team