HIV-HCV Coinfected Patients Develop Liver Cancer at a Younger Age than HCV-monoinfected patients but There Is No Difference in Survival Times between the Two Groups

Although HIV-HCV coinfected individuals develop hepatocellular carcinoma (HCC) at a younger age than persons with patients with hepatitis C monoinfection, there is no difference in the survival rates between the two groups. These were the findings of a retrospective study of 40 HIV-HCV coinfected patients versus 50 HCV-monoinfected patients at 14 Veterans Affairs medical centers in the US and Canada.

As HIV patients live longer due to HAART, they may suffer the consequences of coinfection with the hepatitis C virus (HCV). Few data are available on hepatocellular carcinoma (HCC) in HIV-infected persons. One recent Italian-Spanish study showed that survival of HCC is shorter in HIV-positive than in HIV-negative patients.

A retrospective chart review in 14 US and Canadian medical centers identified 40 HIV/HCV-coinfected patients with HCC. They were compared to 50 HCV-monoinfected control patients.

Results

· Only 1 of 90 patients was female.

· HIV-HCV patients were younger than HCV patients, and they consumed less alcohol.

·  Time from initial HCV infection to HCC was 7.5 years shorter in HIV-HCV compared to HCV patients.

·  HIV/HCV patients had more frequently extrahepatic metastases than HCV patients, but the rate of portal vein thrombosis was the same (7.5% vs. 2.0%).

· Median survival was similar in both groups.

· Both groups were similar in median AFP levels (1,470 vs. 730 ng/ml) and other laboratory values.

· There was also no difference in mean Child-Turcotte-Pugh (CTP) scores (7.5 vs. 7.6), Cancer of the Liver Italian Project (CLIP) tumor staging scores (3.0 vs. 2.7), and frequencies of receiving any HCC therapy (58% vs. 40%, p=0.10).

In conclusion, the authors write, “HIV-HCV-coinfected patients develop HCC at a younger age than HCV-monoinfected patients due to a shorter interval from HCV infection to HCC. In contrast to the European study, we did not find a difference in survival between HIV/HCV and HCV patients.”

08/26/05

Reference
N Bräu and others. Hepatocellular Carcinoma in 40 HIV/HCV-Coinfected versus 50 HCV-Monoinfected Patients. North American HCC in HIV Study Group. Abstract TuPe1.1C17 (poster). 3^rd IAS Conference on HIV Pathogenesis and Treatment. July 24-27, 2005. Rio de Janeiro, Brazil.

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