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Hepatocellular Carcinoma in HIV-Infected Patients: Clinical Presentation and Outcomes in a Racially Diverse Urban Population

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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.

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Author information

Author notes

  1. Angelica D’Aiello and Numa Rahman contributed equally to this work

Authors and Affiliations

  1. Department of Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, 10461, USA

    Angelica D’Aiello & Numa Rahman

  2. Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, 10461, USA

    N. Patrik Brodin & Rafi Kabarriti

  3. Department of Medicine (Hematology & Oncology), Saint Barnabas Medical Center, Livingston, NY, 07039, USA

    Manish Dave & Andreas Kaubisch

  4. Division of Hematology & Medical Oncology, University of Vermont, Larner College of Medicine, Burlington, VT, 05405, USA

    Sakshi Jasra

  5. Division of Hematology & Medical Oncology, NYU Langone Health, New York, NY, 10016, USA

    Jennifer Chuy

Authors
  1. Angelica D’Aiello
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  2. Numa Rahman
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Contributions

Angelica D’Aiello and Numa Rahman contributed equally to this work. All authors contributed substantially to this work.

Corresponding author

Correspondence to Jennifer Chuy.

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Ethics Approval

This study was approved by the Institutional Review Board of the Montefiore Health System.

Conflict of Interest

A. D’Aiello, N. Rahman, N. P. Brodin, M. Dave, S. Jasra, and R. Kabarriti have nothing to disclose. J. Chuy is on the advisory board for Loki Therapeutics. A. Kaubisch is listed as a consultant for Johnson & Johnson.

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D’Aiello, A., Rahman, N., Patrik Brodin, N. et al. Hepatocellular Carcinoma in HIV-Infected Patients: Clinical Presentation and Outcomes in a Racially Diverse Urban Population. J Gastrointest Canc 54, 536–544 (2023). https://doi.org/10.1007/s12029-022-00833-z

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  • DOI: https://doi.org/10.1007/s12029-022-00833-z

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