title: Incidence of hepatocellular carcinoma in hepatitis C cirrhotic patients with and without HIV infection: a cohort study, 1999-2011.
abstract: INTRODUCTION. High activity antiretroviral therapy (HAART) has allowed people infected with human immunodeficiency virus (HIV) to live longer. In the course of time, hepatocellular carcinoma (HCC) began to be found in these patients. Investigations have suggested that, as it has been described for other tumors, HIV infection raises the risk of developing HCC. However, convincing evidence is still required. Our aim was to quantify the incidence of HCC in hepatitis C cirrhotic patients with and without human immunodeficiency virus infection in the HAART era. MATERIAL AND METHOds. This prospective cohort study was conducted in hepatitis C cirrhotic patients with and without HIV co-infection, between june 1, 1999 and May 21, 2010. Ultrasound screening for HCC was performed every 6 to 12 months to all the patients until January 15, 2011. Incidence rate and cumulative incidence (Kaplan-Meier) were calculated. RESULTS. One hundred and forty eight patients (69 hepatitis C virus mono-infected and 79 HIV/hepatitis C virus co-infected) were followed for a median time of 43 months, with a total follow-up of 555 person-years (324 for co-infected and 231 for mono-infected patients). Twelve patients developed HCC (5 co-infected and 7 mono-infected). The incidence of HCC in co-infected patients and mono-infected patients was 1.54 (95% confidence interval = 0.5 to 3.6) and 3.03 (95% confidence interval = 1.22 to 6.23) cases per 100 person-year respectively (log-rank p = 0.3225). CONCLUSION. In the HAART era, HIV co-infection is not associated with a higher incidence of HCC in hepatitis C cirrhotic patients.
authors.affiliation: Hospital Muñiz, Liver Diseases, Buenos Aires, Argentina.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Di Benedetto
authors.affiliation: Hospital Muñiz, Liver Diseases, Buenos Aires, Argentina.
authors.forename: Mirta
authors.initials: M
authors.lastname: Peralta
authors.affiliation: Hospital Posadas, Pathology, Buenos Aires, Argentina.
authors.forename: Estela
authors.initials: E
authors.lastname: Alvarez
authors.affiliation: Hospital Muñiz, Liver Diseases, Buenos Aires, Argentina.
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Schroder
authors.affiliation: Hospital Muñiz, Liver Diseases, Buenos Aires, Argentina.
authors.forename: Claudio
authors.initials: C
authors.lastname: Estepo
authors.affiliation: Hospital Muñiz, Liver Diseases, Buenos Aires, Argentina.
authors.forename: Silvia
authors.initials: S
authors.lastname: Paz
authors.affiliation: Hospital Muñiz, Liver Diseases, Buenos Aires, Argentina.
authors.forename: Hugo
authors.initials: H
authors.lastname: Fainboim
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015331:Cohort Studies; D060085:Coinfection; D055088:Early Detection of Cancer; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008099:Liver / Q000000981:diagnostic imaging; D008103:Liver Cirrhosis / Q000150:complications / Q000453:epidemiology*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014463:Ultrasonography