Mitsuhisa Takatsuki1, Koji Natsuda2, Masaaki Hidaka2, Koji Sawada3, Motohiro Shindo3, Tomoyuki Endo4, Takeshi Hagiwara5, Hiroshi Yotsuyanagi6, Tomohiko Koibuchi6, Kunihisa Tsukada7, Haruka Uemura7, Kazuhiko Hayashi8, Tomoko Uehira9, Eiji Mita10, Masahiro Yamamoto11, Soichiro Takahama11, Susumu Eguchi2. 1. Department of Digestive and General Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. 2. Department of Surgery, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan. 3. Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan. 4. Department of Hematology, Hokkaido University Hospital, Sapporo, Japan. 5. Department of Laboratory Medicine, Tokyo Medical University, Tokyo, Japan. 6. Division of Infectious Diseases, Advanced Clinical Research Center, Institute of Medical Science, The University of Tokyo, Tokyo, Japan. 7. AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan. 8. Department of Gastroenterology and Hepatology, Federation of National Public Service Personnel Mutual Aid Associations, Meijo Hospital, Nagoya, Japan. 9. AIDS Medical Center, National Hospital Organization Osaka National Hospital, Osaka, Japan. 10. Department of Gastroenterology and Hepatology, National Hospital Organization Osaka National Hospital, Osaka, Japan. 11. National Hospital Organization, Kyushu Medical Center, AIDS/HIV Combined Clinic Center, Fukuoka, Japan.
Abstract
BACKGROUND: Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) coinfection through unheated blood product for hemophilia caused in early 1980s has been significantly serious problem in Japan. After the development of HIV treatment in 1990s, HCV-related hepatocellular carcinoma (HCC) has been one of the most significant problem in these population. Treatment choices for HCC might be limited in hemophilia patients because of their bleeding tendency. The aim of this study was to elucidate the treatment choices and outcome of HCC in hemophilic patients coinfected with HIV/HCV due to contaminated blood products. METHODS: We asked 444 Japanese centers that specialize in treating HIV patients for participation, whether they have HIV/HCV coinfected cases with HCC, and the patient characteristics, treatments for HCC and survival after treatments were retrospectively reviewed according to each institutional medical records. RESULTS: Of 444 centers, 139 centers (31%) responded to the first query, and 8 centers (1.8%) ultimately provided 26 cases of HCC in coinfected hemophilic patients, diagnosed between December 1999 and December 2017. All 26 were male hemophilic patients, with a median age at HCC diagnosis of 49 (range, 34-73) years. Thirteen cases (50%) were HCV-RNA positive, and 14 cases (54%) had a solitary tumor. Even in the cases of Child-Pugh grade A, only 1 case underwent resection, and 18 cases (69%) did not receive the standard treatment recommended by the Japanese Society of Hepatology. CONCLUSIONS: Hemophilic HCC patients with HIV/HCV coinfection may not routinely receive standard treatment due to their bleeding tendency and several complications related to HIV/HCV coinfection. 2021 Journal of Gastrointestinal Oncology. All rights reserved.
BACKGROUND: Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) coinfection through unheated blood product for hemophilia caused in early 1980s has been significantly serious problem in Japan. After the development of HIV treatment in 1990s, HCV-related hepatocellular carcinoma (HCC) has been one of the most significant problem in these population. Treatment choices for HCC might be limited in hemophilia patients because of their bleeding tendency. The aim of this study was to elucidate the treatment choices and outcome of HCC in hemophilic patients coinfected with HIV/HCV due to contaminated blood products. METHODS: We asked 444 Japanese centers that specialize in treating HIV patients for participation, whether they have HIV/HCV coinfected cases with HCC, and the patient characteristics, treatments for HCC and survival after treatments were retrospectively reviewed according to each institutional medical records. RESULTS: Of 444 centers, 139 centers (31%) responded to the first query, and 8 centers (1.8%) ultimately provided 26 cases of HCC in coinfected hemophilic patients, diagnosed between December 1999 and December 2017. All 26 were male hemophilic patients, with a median age at HCC diagnosis of 49 (range, 34-73) years. Thirteen cases (50%) were HCV-RNA positive, and 14 cases (54%) had a solitary tumor. Even in the cases of Child-Pugh grade A, only 1 case underwent resection, and 18 cases (69%) did not receive the standard treatment recommended by the Japanese Society of Hepatology. CONCLUSIONS: Hemophilic HCC patients with HIV/HCV coinfection may not routinely receive standard treatment due to their bleeding tendency and several complications related to HIV/HCV coinfection. 2021 Journal of Gastrointestinal Oncology. All rights reserved.
Entities:
Keywords:
Human immunodeficiency virus (HIV); coinfection; hemophilia; hepatitis C virus (HCV); hepatocellular carcinoma (HCC)
Authors: L Martín-Carbonero; P Tuma; E Vispo; J Medrano; P Labarga; J González-Lahoz; P Barreiro; V Soriano Journal: J Viral Hepat Date: 2010-08-31 Impact factor: 3.728
Authors: Mark S Sulkowski; Shruti H Mehta; Michael S Torbenson; Yvonne Higgins; Sherilyn C Brinkley; Ruben Montes de Oca; Richard D Moore; Nezam H Afdhal; David L Thomas Journal: AIDS Date: 2007-10-18 Impact factor: 4.177
Authors: Soraia M Machado; Aline G Vigani; Andrea G Leite; Ana Claudia M Diaz; Paulo Roberto A Ferreira; Dimas Carnaúba-Júnior; Simone B Tenore; Carlos Eduardo Brandão-Mello; Mario P Gonzalez; Fabiana Siroma; Kleber D Prado; Delzi V Nunes; Gaspar Lisboa-Neto; João Renato R Pinho; Fernanda M Malta; Raymundo S Azevedo; Steven S Witkin; Maria Cássia Mendes-Correa Journal: Medicine (Baltimore) Date: 2020-07-24 Impact factor: 1.817