title: Increasing incidence of hepatocellular carcinoma in HIV-infected patients in Spain.
abstract: BACKGROUND
  To report the clinical and epidemiological characteristics of hepatocellular carcinoma (HCC) diagnosed in a cohort of human immunodeficiency virus (HIV)-infected patients in Spain.
  
  
  METHODS
  All HIV-infected patients diagnosed of HCC in 18 hospitals in Spain before 31 December 2010 were included. The main characteristics of HCC cases are described and comparisons between cases according to the year of diagnosis are presented.
  
  
  RESULTS
  Eighty-two cases of HCC in HIV-infected patients were included, all of them related to viral hepatitis coinfection: hepatitis C virus (HCV) in 66 (81%), hepatitis B virus (HBV) in 6 (7%), and HBV/HCV in 10 (12%). From 1999, when the first case of HCC was diagnosed, a progressive increment in the incidence of HCC in the cohort has occurred. In patients coinfected with HIV/HCV-coinfected patients, the incidence HCC increased from 0.2 to 2.8 cases per 1000 person-years between 2000 and 2009. Death occurred in 65 patients (79%), with a median survival of 91 days (interquartile range, 31-227 days). Three of 11 patients (28%) who received potentially curative therapy died, compared with 62 of 71 patients (87%) who did not receive curative therapy (P = .0001). Compared with cases of HCC diagnosed before 2005, cases diagnosed later did not show a higher survival rate.
  
  
  CONCLUSIONS
  HCC is an emerging complication of cirrhosis in HIV-infected patients. A sharp increase in its incidence has occurred in those also infected by HCV in the recent years. Unfortunately, HCC is frequently diagnosed at an advanced stage, and mortality continues to be very high, with no significant changes in recent years. Earlier diagnosis, which may allow potentially curative therapy, is necessary.
authors.affiliation: Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Avenida de Bellavista s/n, Sevilla 41014, Spain. japineda@telefonica.net
authors.forename: Nicolás
authors.initials: N
authors.lastname: Merchante
authors.forename: Esperanza
authors.initials: E
authors.lastname: Merino
authors.forename: José
authors.initials: J
authors.lastname: López-Aldeguer
authors.forename: Francisco
authors.initials: F
authors.lastname: Jover
authors.forename: Marcial
authors.initials: M
authors.lastname: Delgado-Fernández
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Galindo
authors.forename: Enrique
authors.initials: E
authors.lastname: Ortega
authors.forename: Antonio
authors.initials: A
authors.lastname: Rivero
authors.forename: Carlos
authors.initials: C
authors.lastname: Mínguez
authors.forename: Alberto
authors.initials: A
authors.lastname: Romero-Palacios
authors.forename: Sergio
authors.initials: S
authors.lastname: Padilla
authors.forename: Manuel
authors.initials: M
authors.lastname: Márquez-Solero
authors.forename: Concepción
authors.initials: C
authors.lastname: Amador
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Ríos-Villegas
authors.forename: Francisco
authors.initials: F
authors.lastname: Téllez
authors.forename: Joaquín
authors.initials: J
authors.lastname: Portilla
authors.forename: Juan A
authors.initials: JA
authors.lastname: Pineda
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000821:virology; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D006509:Hepatitis B / Q000453:epidemiology / Q000821:virology; D006526:Hepatitis C / Q000453:epidemiology / Q000821:virology; D006801:Humans; D015994:Incidence; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000821:virology; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013030:Spain / Q000453:epidemiology; D016019:Survival Analysis