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  • Oral presentation
  • Open Access

Carcinovic cohort: prognostic factors of death in HIV/HCV coinfected patients with hepatocellular carcinoma (HCC)

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BMC Infectious Diseases201414 (Suppl 2) :O15

https://doi.org/10.1186/1471-2334-14-S2-O15

  • Published:

Keywords

  • Carcinoma
  • Prognostic Factor
  • Hepatocellular Carcinoma
  • Median Serum
  • Liver Disorder

Background and aim

We have previously reported a more advanced radiological presentation in HIV+/HCV+ than HIV-/HCV+ patients (pts). The aim of our study was to define prognostic factors of death in HIV+/HCV+ pts with HCC.

Methods

Cases of HCC in HIV+/HCV+ pts were obtained from the 3 ANRS Prethevic, HepaVih and CirVir cohorts. Imaging was reviewed according to EASL criteria.

Results

Fifty HIV+/HCV+ coinfected pts (n=44 men (88%), median age 50 years [40-74], median CD4 cell count 334/mm3 [58-1621], n=28 Child A cirrhosis (60%)) developed HCC. Thirty-one (63%) pts presented cirrhosis decompensation before HCC diagnosis. At HCC diagnosis, median serum aFP was 20.4 [1.9-198,900] ng/ml, 38 (76%) pts had a nodular tumor (median main diameter 23.5 [11-70] cm) and 12 (24%) pts an infiltrating form (62.5 [10-130] cm), p=0.007. Tumor portal thrombosis was diagnosed in 14 (28%) pts. A curative or a palliative procedure was further performed in 22 (44%) pts and 20 (40%) pts, respectively. The 2-years and 4-years overall survival rates were 51% and 28%, respectively. Age (p=0.0005), infiltrating or nodular tumor (p= 0.0009) and tumor portal thrombosis (p=0.004) were associated to survival. In a Cox model, two prognostic factors of deaths were found: prior episode of cirrhosis decompensation (aRR 11.43 [3.01-43.34], p=0.0003) and tumor portal thrombosis (aRR 4.66 [1.19-18.27], p=0.03), adjusted on age, CD4 cell count and the therapeutic strategy for HCC.

Conclusions

Cirrhosis decompensation and tumor portal thrombosis significantly impact the survival of HIV+/HCV+ pts with HCC. Our results suggest new rules of screening HCC in HIV+/HCV+ pts with advanced liver disorders.

Authors’ Affiliations

(1)
Paul Brousse Hospital, Villejuif, France

Copyright

© Gelu-Simeon et al; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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