Angelica D'Aiello1, Numa Rahman1, N Patrik Brodin2, Manish Dave3, Sakshi Jasra4, Andreas Kaubisch3, Rafi Kabarriti2, Jennifer Chuy5. 1. Department of Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, 10461, USA. 2. Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, 10461, USA. 3. Department of Medicine (Hematology & Oncology), Saint Barnabas Medical Center, Livingston, NY, 07039, USA. 4. Division of Hematology & Medical Oncology, University of Vermont, Larner College of Medicine, Burlington, VT, 05405, USA. 5. Division of Hematology & Medical Oncology, NYU Langone Health, New York, NY, 10016, USA. jennifer.chuy@nyulangone.org.
Abstract
PURPOSE: As life expectancy for HIV patients improve, hepatocellular carcinoma (HCC) has become a non-AIDS defining illness with a high impact on morbidity and mortality of HIV-infected individuals. We sought to compare outcomes in HIV- versus non-HIV-infected patients treated for HCC at a multiethnic academic medical health system. METHODS: A retrospective chart review of patients diagnosed with HCC from 1/1/2005 to 12/31/2016 was performed. Differences in characteristics among HIV and non-HIV subjects were assessed. Associations between HIV status, viral load, CD4 count, and overall survival (OS) were also assessed. RESULTS: We identified 915 subjects (842 non-HIV and 73 with HIV). HIV-infected subjects were younger, predominantly male non-Hispanic Blacks, and more likely to have HBV and HCV co-infection, and alcohol use at diagnosis compared to non-HIV counterparts. Stage, MELD score, Child-Pugh, and ECOG performance status were similar. HIV-positive patients received systemic therapy at significantly higher rates and liver transplantation for HCC at significantly lower rates than those without HIV. The actuarial 3- and 5-year overall survival (OS) for all patients was 48.3% and 39.4%. For HIV-infected subjects, 3- and 5-year OS was significantly worse at 36.8% and 28.3% compared to 49.3% and 40.4%, respectively, for non-HIV subjects (log rank p = 0.033). CONCLUSIONS: HIV-infected HCC patients have lower survival rates compared to those without HIV. Despite younger age and similar stage, MELD, and ECOG at diagnosis, HIV portends worse outcomes in patients with HCC.
PURPOSE: As life expectancy for HIV patients improve, hepatocellular carcinoma (HCC) has become a non-AIDS defining illness with a high impact on morbidity and mortality of HIV-infected individuals. We sought to compare outcomes in HIV- versus non-HIV-infected patients treated for HCC at a multiethnic academic medical health system. METHODS: A retrospective chart review of patients diagnosed with HCC from 1/1/2005 to 12/31/2016 was performed. Differences in characteristics among HIV and non-HIV subjects were assessed. Associations between HIV status, viral load, CD4 count, and overall survival (OS) were also assessed. RESULTS: We identified 915 subjects (842 non-HIV and 73 with HIV). HIV-infected subjects were younger, predominantly male non-Hispanic Blacks, and more likely to have HBV and HCV co-infection, and alcohol use at diagnosis compared to non-HIV counterparts. Stage, MELD score, Child-Pugh, and ECOG performance status were similar. HIV-positive patients received systemic therapy at significantly higher rates and liver transplantation for HCC at significantly lower rates than those without HIV. The actuarial 3- and 5-year overall survival (OS) for all patients was 48.3% and 39.4%. For HIV-infected subjects, 3- and 5-year OS was significantly worse at 36.8% and 28.3% compared to 49.3% and 40.4%, respectively, for non-HIV subjects (log rank p = 0.033). CONCLUSIONS: HIV-infected HCC patients have lower survival rates compared to those without HIV. Despite younger age and similar stage, MELD, and ECOG at diagnosis, HIV portends worse outcomes in patients with HCC.
Authors: George N Ioannou; Christopher L Bryson; Noel S Weiss; Richard Miller; John D Scott; Edward J Boyko Journal: Hepatology Date: 2013-01 Impact factor: 17.425
Authors: Michael J Silverberg; Bryan Lau; Chad J Achenbach; Yuezhou Jing; Keri N Althoff; Gypsyamber D'Souza; Eric A Engels; Nancy A Hessol; John T Brooks; Ann N Burchell; M John Gill; James J Goedert; Robert Hogg; Michael A Horberg; Gregory D Kirk; Mari M Kitahata; Philip T Korthuis; William C Mathews; Angel Mayor; Sharada P Modur; Sonia Napravnik; Richard M Novak; Pragna Patel; Anita R Rachlis; Timothy R Sterling; James H Willig; Amy C Justice; Richard D Moore; Robert Dubrow Journal: Ann Intern Med Date: 2015-10-06 Impact factor: 25.391
Authors: Massimo Puoti; Raffaele Bruno; Vincent Soriano; Francesco Donato; Giovanni Battista Gaeta; Gian Paolo Quinzan; Davide Precone; Umberto Gelatti; Victor Asensi; Emanuela Vaccher Journal: AIDS Date: 2004-11-19 Impact factor: 4.177