OBJECTIVE: It has been suggested that HIV infection has a detrimental impact on patients with hepatocellular carcinoma (HCC). The present study sought to test this hypothesis, while controlling for tumor extension and liver disease. DESIGN AND SETTING: A case control and a cohort approach were performed in patients with HCC managed prospectively via dedicated multidisciplinary team meeting in a single tertiary institution between 2004 and 2009. SUBJECTS: Of 473 consecutive treatment-naive patients with HCC, 23 were HIV-positive (HIV) and 450 were HIV-negative (HIV). HIV patients were matched 1:2 with a control group of HIV patients in terms of the etiology of HCC, the severity of liver disease, tumor extension, and year of diagnosis. INTERVENTION: Curative or palliative treatment of HCC. MAIN OUTCOME MEASURES: Eligibility for HCC treatment, the treatment actually administered, and the survival rate. RESULTS: The HIV population was younger than the HIV population (mean age: 49 vs. 61 years, respectively; P < 0.0001). Curative treatment was recommended by the multidisciplinary team meeting and then actually performed to a similar extent in HIV patients (74% and 43%, respectively) and their matched HIV controls (74% and 56%, respectively). The HIV and their matched HIV patients did not differ significantly in terms of the 3-year survival rate [44% vs. 48%, respectively; mean (95% confidence interval) hazard ratio = 0.64 (0.3-1.3); P = 0.2]. In a cohort analysis, HIV status was not an independent predictor of survival among curatively treated patients. CONCLUSION: In an equal-access unbiased environment, HIV status does not significantly influence treatment access, delivery, and outcome.
OBJECTIVE: It has been suggested that HIV infection has a detrimental impact on patients with hepatocellular carcinoma (HCC). The present study sought to test this hypothesis, while controlling for tumor extension and liver disease. DESIGN AND SETTING: A case control and a cohort approach were performed in patients with HCC managed prospectively via dedicated multidisciplinary team meeting in a single tertiary institution between 2004 and 2009. SUBJECTS: Of 473 consecutive treatment-naive patients with HCC, 23 were HIV-positive (HIV) and 450 were HIV-negative (HIV). HIV patients were matched 1:2 with a control group of HIV patients in terms of the etiology of HCC, the severity of liver disease, tumor extension, and year of diagnosis. INTERVENTION: Curative or palliative treatment of HCC. MAIN OUTCOME MEASURES: Eligibility for HCC treatment, the treatment actually administered, and the survival rate. RESULTS: The HIV population was younger than the HIV population (mean age: 49 vs. 61 years, respectively; P < 0.0001). Curative treatment was recommended by the multidisciplinary team meeting and then actually performed to a similar extent in HIV patients (74% and 43%, respectively) and their matched HIV controls (74% and 56%, respectively). The HIV and their matched HIV patients did not differ significantly in terms of the 3-year survival rate [44% vs. 48%, respectively; mean (95% confidence interval) hazard ratio = 0.64 (0.3-1.3); P = 0.2]. In a cohort analysis, HIV status was not an independent predictor of survival among curatively treated patients. CONCLUSION: In an equal-access unbiased environment, HIV status does not significantly influence treatment access, delivery, and outcome.
Authors: Scott Dryden-Peterson; Memory Bvochora-Nsingo; Gita Suneja; Jason A Efstathiou; Surbhi Grover; Sebathu Chiyapo; Doreen Ramogola-Masire; Malebogo Kebabonye-Pusoentsi; Rebecca Clayman; Abigail C Mapes; Neo Tapela; Aida Asmelash; Heluf Medhin; Akila N Viswanathan; Anthony H Russell; Lilie L Lin; Mukendi K A Kayembe; Mompati Mmalane; Thomas C Randall; Bruce Chabner; Shahin Lockman Journal: J Clin Oncol Date: 2016-11-01 Impact factor: 44.544