title: Outcome of hepatocellular carcinoma in human immunodeficiency virus-infected patients.
abstract: BACKGROUND
  Although the number of human immunodeficiency virus-infected patients with chronic liver disease is increasing, the impact of human immunodeficiency virus on hepatocellular carcinoma outcome remains unclear.
  
  
  OBJECTIVE
  This single centre study investigated whether human immunodeficiency virus infection per se affects the hepatocellular carcinoma prognosis.
  
  
  METHODS
  Forty-eight human immunodeficiency virus-infected and 234 uninfected patients consecutively diagnosed with hepatitis virus-related hepatocellular carcinoma from January 2000 to December 2009 were retrospectively enrolled. Hepatocellular carcinoma was staged according to Cancer of the Liver Italian Program criteria. Survival and independent prognostic predictors were evaluated. Survivals were also compared after adjustment and matching by propensity score.
  
  
  RESULTS
  Compared to human immunodeficiency virus-uninfected subjects, infected patients were more likely to be males, were younger, had fewer comorbidities and the tumour was more often detected during surveillance. Liver function, tumour characteristics and treatments did not significantly differ between the two groups. Nevertheless, median survival of human immunodeficiency virus-infected patients was approximately half that of their counterpart (16 months [95% confidence interval: 7-25] vs. 30 months [95% confidence interval: 25-35]; p=0.0354). Human immunodeficiency virus infection, Cancer of the Liver Italian Program score and hepatocellular carcinoma treatment were independently associated with mortality. Notably, human immunodeficiency virus infection doubled the risk of dying. These results were confirmed by propensity analysis.
  
  
  CONCLUSIONS
  Human immunodeficiency virus infection per se worsens the prognosis of patients with virus-related hepatocellular carcinoma.
authors: Department of Medical and Surgical Sciences, Semeiotics Unit, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
authors: Annagiulia
authors: A
authors: Gramenzi
authors: Sara
authors: S
authors: Tedeschi
authors: Maria Chiara
authors: MC
authors: Cantarini
authors: Virginia
authors: V
authors: Erroi
authors: Fabio
authors: F
authors: Tumietto
authors: Luciano
authors: L
authors: Attard
authors: Leonardo
authors: L
authors: Calza
authors: Francesco Giuseppe
authors: FG
authors: Foschi
authors: Paolo
authors: P
authors: Caraceni
authors: Michele
authors: M
authors: Pavoni
authors: Alessandro
authors: A
authors: Cucchetti
authors: Mauro
authors: M
authors: Bernardi
authors: Pierluigi
authors: P
authors: Viale
authors: Gabriella
authors: G
authors: Verucchi
authors: Franco
authors: F
authors: Trevisani
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology*; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D057216:Propensity Score; D012189:Retrospective Studies; D015996:Survival Rate