title: Human immunodeficiency virus infection does not worsen prognosis of liver transplantation for hepatocellular carcinoma.
abstract: The impact of human immunodeficiency virus (HIV) infection on patients undergoing liver transplantation (LT) for hepatocellular carcinoma (HCC) is uncertain. This study aimed to assess the outcome of a prospective Spanish nationwide cohort of HIV-infected patients undergoing LT for HCC (2002-2014). These patients were matched (age, gender, year of LT, center, and hepatitis C virus (HCV) or hepatitis B virus infection) with non-HIV-infected controls (1:3 ratio). Patients with incidental HCC were excluded. Seventy-four HIV-infected patients and 222 non-HIV-infected patients were included. All patients had cirrhosis, mostly due to HCV infection (92%). HIV-infected patients were younger (47 versus 51 years) and had undetectable HCV RNA at LT (19% versus 9%) more frequently than non-HIV-infected patients. No significant differences were detected between HIV-infected and non-HIV-infected recipients in the radiological characteristics of HCC at enlisting or in the histopathological findings for HCC in the explanted liver. Survival at 1, 3, and 5 years for HIV-infected versus non-HIV-infected patients was 88% versus 90%, 78% versus 78%, and 67% versus 73% (P = 0.779), respectively. HCV infection (hazard ratio = 7.90, 95% confidence interval 1.07-56.82) and maximum nodule diameter >3 cm in the explanted liver (hazard ratio = 1.72, 95% confidence interval 1.02-2.89) were independently associated with mortality in the whole series. HCC recurred in 12 HIV-infected patients (16%) and 32 non-HIV-infected patients (14%), with a probability of 4% versus 5% at 1 year, 18% versus 12% at 3 years, and 20% versus 19% at 5 years (P = 0.904). Microscopic vascular invasion (hazard ratio = 3.40, 95% confidence interval 1.34-8.64) was the only factor independently associated with HCC recurrence.
  
  
  CONCLUSIONS
  HIV infection had no impact on recurrence of HCC or survival after LT. Our results support the indication of LT in HIV-infected patients with HCC.
authors.affiliation: Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Agüero
authors.affiliation: Barcelona Clinic Liver Cancer (BCLC) Group, Liver Unit, Hospital Clinic- IDIBAPS, Barcelona, Spain.|CIBEREHD (Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas), Madrid, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Forner
authors.affiliation: Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Christian
authors.initials: C
authors.lastname: Manzardo
authors.affiliation: Hospital Universitario Cruces, Bilbao, Spain.|University of Basque Country, Bilbao, Spain.
authors.forename: Andres
authors.initials: A
authors.lastname: Valdivieso
authors.affiliation: Hospital Universitario y Politécnic La Fe, Valencia, Spain.
authors.forename: Marino
authors.initials: M
authors.lastname: Blanes
authors.affiliation: Hospital Universitario Ramón y Cajal, Madrid, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Barcena
authors.affiliation: Hospital de Bellvitge-IDIBELL, University of Barcelona, Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Rafecas
authors.affiliation: CIBEREHD (Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas), Madrid, Spain.|Hospital Universitario Vall d'Hebrón, Barcelona, Spain.
authors.forename: Lluis
authors.initials: L
authors.lastname: Castells
authors.affiliation: Servicio de Cirugía, Hospital Doce de Octubre, Madrid, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Abradelo
authors.affiliation: Hospital Universitario Reina Sofía-IMIBIC, University of Córdoba, Córdoba, Spain.
authors.forename: Julian
authors.initials: J
authors.lastname: Torre-Cisneros
authors.affiliation: Liver Unit, Division of Gastroenterology and Hepatology, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Luisa
authors.initials: L
authors.lastname: Gonzalez-Dieguez
authors.affiliation: Department of Liver Transplantation, Hospital General Gregorio Marañón, Madrid, Spain.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Salcedo
authors.affiliation: Liver Unit, University Hospital Lozano Blesa Zaragoza, IIS Aragon, Spain.
authors.forename: Trinidad
authors.initials: T
authors.lastname: Serrano
authors.affiliation: Unidad de Gestión Clínica de Enfermedades Digestivas, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario Carlos Haya, Málaga, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Jimenez-Perez
authors.affiliation: CIBEREHD (Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas), Madrid, Spain.|Liver Unit, Clinica Universidad de Navarra, Pamplona, Spain.|Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.
authors.forename: Jose Ignacio
authors.initials: JI
authors.lastname: Herrero
authors.affiliation: Hospital Universitario Cruces, Bilbao, Spain.|University of Basque Country, Bilbao, Spain.
authors.forename: Mikel
authors.initials: M
authors.lastname: Gastaca
authors.affiliation: CIBEREHD (Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas), Madrid, Spain.|Hospital Universitario y Politécnic La Fe, Valencia, Spain.
authors.forename: Victoria
authors.initials: V
authors.lastname: Aguilera
authors.affiliation: Hospital de Bellvitge-IDIBELL, University of Barcelona, Barcelona, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Fabregat
authors.affiliation: Hospital Universitario Ramón y Cajal, Madrid, Spain.
authors.forename: Santos
authors.initials: S
authors.lastname: Del Campo
authors.affiliation: Hospital Universitario Vall d'Hebrón, Barcelona, Spain.
authors.forename: Itxarone
authors.initials: I
authors.lastname: Bilbao
authors.affiliation: Servicio de Cirugía, Hospital Doce de Octubre, Madrid, Spain.
authors.forename: Carlos Jimenez
authors.initials: CJ
authors.lastname: Romero
authors.affiliation: Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Asuncion
authors.initials: A
authors.lastname: Moreno
authors.affiliation: CIBEREHD (Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas), Madrid, Spain.|Liver Unit, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Rimola
authors.affiliation: Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Miro
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000601:surgery*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies