title: Human immunodeficiency virus-infected liver transplant recipients with incidental hepatocellular carcinoma: A prospective multicenter nationwide cohort study.
abstract: There is a lack of data on incidental hepatocellular carcinoma (iHCC) in the setting of liver transplantation (LT) in human immunodeficiency virus (HIV)-infected patients. This study aims to describe the frequency, histopathological characteristics, and outcomes of HIV+ LT recipients with iHCC from a Spanish multicenter cohort in comparison with a matched cohort of LT patients without HIV infection. A total of 15 (6%) out of 271 patients with HIV infection who received LT in Spain from 2002 to 2012 and 38 (5%) out of the 811 HIV- counterparts presented iHCC in liver explants (P = 0.58). Patients with iHCC constitute the present study population. All patients also had hepatitis C virus (HCV)-related cirrhosis. There were no significant differences in histopathological features of iHCC between the 2 groups. Most patients showed a small number and size of tumoral nodules, and few patients had satellite nodules, microvascular invasion, or poorly differentiated tumors. After a median follow-up of 49 months, no patient developed hepatocellular carcinoma (HCC) recurrence after LT. HIV+ LT recipients tended to have lower survival than their HIV- counterparts at 1 (73% versus 92%), 3 (67% versus 84%), and 5 years (50% versus 80%; P = 0.06). There was also a trend to a higher frequency of HCV recurrence as a cause of death in the former (33% versus 10%; P = 0.097). In conclusion, among LT recipients for HCV-related cirrhosis, the incidence and histopathological features of iHCC in HIV+ and HIV- patients were similar. However, post-LT survival was lower in HIV+ patients probably because of a more aggressive HCV recurrence. Liver Transplantation 23 645-651 2017 AASLD.
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.|Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Forner
authors.affiliation: Hospital Universitario de Cruces-Universidad del País Vasco, Bilbao, Spain.
authors.forename: Andrés
authors.initials: A
authors.lastname: Valdivieso
authors.affiliation: Hospital Universitario 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 Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Christian
authors.initials: C
authors.lastname: Manzardo
authors.affiliation: Hospital de Bellvitge-IDIBELL, University of Barcelona, Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Rafecas
authors.affiliation: Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas (CIBEREHD), 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: Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain.|Hospital Universitario Reina Sofía-IMIBIC, University of Córdoba, Córdoba, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Barrera-Baena
authors.affiliation: Liver Unit, Division of Gastroenterology and Hepatology, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Luisa
authors.initials: L
authors.lastname: González-Diéguez
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-IIS Aragon, Zaragoza, 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: Jiménez-Pérez
authors.affiliation: Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain.|Liver Unit, Clinica Universidad de Navarra, Pamplona, Spain.|Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.
authors.forename: José Ignacio
authors.initials: JI
authors.lastname: Herrero
authors.affiliation: Hospital Universitario de Cruces-Universidad del País Vasco, Bilbao, Spain.
authors.forename: Mikel
authors.initials: M
authors.lastname: Gastaca
authors.affiliation: Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain.|Hospital Universitario 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 Jiménez
authors.initials: CJ
authors.lastname: Romero
authors.affiliation: Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Asunción
authors.initials: A
authors.lastname: Moreno
authors.affiliation: Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas (CIBEREHD), 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: José M
authors.initials: JM
authors.lastname: Miro
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000150:complications*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D017093:Liver Failure / Q000150:complications* / Q000601:surgery; D008113:Liver Neoplasms / Q000150:complications*; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology