Lars I Gjærde1, Leah Shepherd2, Elzbieta Jablonowska3, Adriano Lazzarin4, Mathieu Rougemont5, Katharine Darling6, Manuel Battegay7, Dominique Braun8, Valerie Martel-Laferriere9, Jens D Lundgren10, Jürgen K Rockstroh11, John Gill12, Andri Rauch13, Amanda Mocroft2, Marina B Klein14, Lars Peters10. 1. Faculty of Health and Medical Sciences, University of Copenhagen, Denmark. 2. Department of Infection and Population Health, University College London, United Kingdom. 3. Department of Infectious Diseases and Hepatology, Medical University of Lodz, Poland. 4. Department of Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy. 5. Division of Infectious Diseases, University Hospital Geneva. 6. Service of Infectious Diseases, Lausanne University Hospital. 7. Divisions of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel. 8. Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Switzerland. 9. Department of Microbiology and Infectious Diseases, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Canada. 10. Centre for Health & Infectious Disease Research, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Denmark. 11. University of Bonn, Germany. 12. Department of Medicine, University of Calgary, Alberta, Canada. 13. Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Switzerland. 14. Department of Medicine, Chronic Viral Illness Service, McGill University Health Center, Montreal, Canada.
Abstract
BACKGROUND: While liver-related deaths in human immunodeficiency virus (HIV) and hepatitis C virus (HCV)-coinfected individuals have declined over the last decade, hepatocellular carcinoma (HCC) may have increased. We describe the epidemiology of HCC and other liver events in a multicohort collaboration of HIV/HCV-coinfected individuals. METHODS: We studied HCV antibody-positive adults with HIV in the EuroSIDA study, the Southern Alberta Clinic Cohort, the Canadian Co-infection Cohort, and the Swiss HIV Cohort study from 2001 to 2014. We calculated the incidence of HCC and other liver events (defined as liver-related deaths or decompensations, excluding HCC) and used Poisson regression to estimate incidence rate ratios. RESULTS: Our study comprised 7229 HIV/HCV-coinfected individuals (68% male, 90% white). During follow-up, 72 cases of HCC and 375 other liver events occurred, yielding incidence rates of 1.6 (95% confidence interval [CI], 1.3, 2.0) and 8.6 (95% CI, 7.8, 9.5) cases per 1000 person-years of follow-up, respectively. The rate of HCC increased 11% per calendar year (95% CI, 4%, 19%) and decreased 4% for other liver events (95% CI, 2%, 7%), but only the latter remained statistically significant after adjustment for potential confounders. Older age, cirrhosis, and low current CD4 cell count were associated with a higher incidence of both HCC and other liver events. CONCLUSIONS: In HIV/HCV-coinfected individuals, the crude incidence of HCC increased from 2001 to 2014, while other liver events declined. Individuals with cirrhosis or low current CD4 cell count are at highest risk of developing HCC or other liver events.
BACKGROUND: While liver-related deaths in human immunodeficiency virus (HIV) and hepatitis C virus (HCV)-coinfected individuals have declined over the last decade, hepatocellular carcinoma (HCC) may have increased. We describe the epidemiology of HCC and other liver events in a multicohort collaboration of HIV/HCV-coinfected individuals. METHODS: We studied HCV antibody-positive adults with HIV in the EuroSIDA study, the Southern Alberta Clinic Cohort, the Canadian Co-infection Cohort, and the Swiss HIV Cohort study from 2001 to 2014. We calculated the incidence of HCC and other liver events (defined as liver-related deaths or decompensations, excluding HCC) and used Poisson regression to estimate incidence rate ratios. RESULTS: Our study comprised 7229 HIV/HCV-coinfected individuals (68% male, 90% white). During follow-up, 72 cases of HCC and 375 other liver events occurred, yielding incidence rates of 1.6 (95% confidence interval [CI], 1.3, 2.0) and 8.6 (95% CI, 7.8, 9.5) cases per 1000 person-years of follow-up, respectively. The rate of HCC increased 11% per calendar year (95% CI, 4%, 19%) and decreased 4% for other liver events (95% CI, 2%, 7%), but only the latter remained statistically significant after adjustment for potential confounders. Older age, cirrhosis, and low current CD4 cell count were associated with a higher incidence of both HCC and other liver events. CONCLUSIONS: In HIV/HCV-coinfected individuals, the crude incidence of HCC increased from 2001 to 2014, while other liver events declined. Individuals with cirrhosis or low current CD4 cell count are at highest risk of developing HCC or other liver events.
Authors: Daniel Grint; Lars Peters; Juergen K Rockstroh; Aza Rakmanova; Tatiana Trofimova; Karine Lacombe; Igor Karpov; Massimo Galli; Pere Domingo; Ole Kirk; Jens D Lundgren; Amanda Mocroft Journal: AIDS Date: 2015-06-19 Impact factor: 4.177
Authors: Norbert Bräu; Mirella Salvatore; Carlos F Ríos-Bedoya; Alberto Fernández-Carbia; Fiorenzo Paronetto; José F Rodríguez-Orengo; Maribel Rodríguez-Torres Journal: J Hepatol Date: 2005-07-27 Impact factor: 25.083
Authors: Colette J Smith; Lene Ryom; Rainer Weber; Philippe Morlat; Christian Pradier; Peter Reiss; Justyna D Kowalska; Stephane de Wit; Matthew Law; Wafaa el Sadr; Ole Kirk; Nina Friis-Moller; Antonella d'Arminio Monforte; Andrew N Phillips; Caroline A Sabin; Jens D Lundgren Journal: Lancet Date: 2014-07-19 Impact factor: 79.321
Authors: Jennifer R Kramer; Marc A Kowalkowski; Zhigang Duan; Elizabeth Y Chiao Journal: J Acquir Immune Defic Syndr Date: 2015-04-01 Impact factor: 3.731
Authors: Dominique Salmon; Firouzé Bani-Sadr; Marc-Arthur Loko; Hind Stitou; Anne Gervais; Jacques Durant; Eric Rosenthal; Yann Quertainmont; Karl Barange; Daniel Vittecoq; Michka Shoai-Tehrani; Muriel Alvarez; Maria Winnock; Jean Claude Trinchet; François Dabis; Philippe Sogni Journal: J Hepatol Date: 2011-12-13 Impact factor: 25.083
Authors: Vincent Lo Re; Michael J Kallan; Janet P Tate; A Russell Localio; Joseph K Lim; Matthew Bidwell Goetz; Marina B Klein; David Rimland; Maria C Rodriguez-Barradas; Adeel A Butt; Cynthia L Gibert; Sheldon T Brown; Lesley Park; Robert Dubrow; K Rajender Reddy; Jay R Kostman; Brian L Strom; Amy C Justice Journal: Ann Intern Med Date: 2014-03-18 Impact factor: 25.391
Authors: Gary M Clifford; Martin Rickenbach; Jerry Polesel; Luigino Dal Maso; Ingrid Steffen; Bruno Ledergerber; Andri Rauch; Nicole M Probst-Hensch; Christine Bouchardy; Fabio Levi; Silvia Franceschi Journal: AIDS Date: 2008-10-18 Impact factor: 4.177
Authors: Jeffrey P Anderson; C Robert Horsburgh; Paige L Williams; Eric J Tchetgen Tchetgen; David Nunes; Deborah Cotton; George R Seage Journal: Open Forum Infect Dis Date: 2015-02-28 Impact factor: 3.835
Authors: D Grint; L Peters; C Schwarze-Zander; M Beniowski; C Pradier; M Battegay; D Jevtovic; V Soriano; J D Lundgren; J K Rockstroh; O Kirk; A Mocroft Journal: HIV Med Date: 2013-07-19 Impact factor: 3.180
Authors: Kasha P Singh; Megan Crane; Jennifer Audsley; Anchalee Avihingsanon; Joe Sasadeusz; Sharon R Lewin Journal: AIDS Date: 2017-09-24 Impact factor: 4.177
Authors: Jessie Torgersen; Michael J Kallan; Dena M Carbonari; Lesley S Park; Rajni L Mehta; Kathryn D'Addeo; Janet P Tate; Joseph K Lim; Matthew Bidwell Goetz; Maria C Rodriguez-Barradas; Cynthia L Gibert; Norbert Bräu; Sheldon T Brown; Jason A Roy; Tamar H Taddei; Amy C Justice; Vincent Lo Re Journal: J Natl Cancer Inst Date: 2020-07-01 Impact factor: 13.506
Authors: Allison R Webel; Julie Schexnayder; Patricia A Cioe; Julie A Zuñiga Journal: J Assoc Nurses AIDS Care Date: 2021 May-Jun 01 Impact factor: 1.809
Authors: Jim Young; Vincent Lo Re; H Nina Kim; Timothy R Sterling; Keri N Althoff; Kelly A Gebo; M John Gill; Michael A Horberg; Angel M Mayor; Richard D Moore; Michael J Silverberg; Marina B Klein Journal: Pharmacoepidemiol Drug Saf Date: 2021-11-23 Impact factor: 2.732
Authors: Isabel Campos-Varela; Jennifer L Dodge; Marina Berenguer; René Adam; Didier Samuel; Fabrizio Di Benedetto; Vincent Karam; Luca S Belli; Christophe Duvoux; Norah A Terrault Journal: Transplantation Date: 2020-10 Impact factor: 5.385