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HIV did not affect HCC recurrence or survival after LT

Issue: April 25, 2015

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Survival and recurrence rates were unaffected by HIV infection among patients who underwent liver transplantation for hepatocellular carcinoma, according to a poster presentation at CROI 2015.

In this prospective cohort study, 74 patients with HIV and HCC who underwent liver transplantation across 22 clinical centers in Spain were matched in a 1:3 ratio with 222 non–HIV-infected patients with HCC who underwent liver transplantation to determine whether HIV infection affected survival or recurrence rates for HCC after liver transplantation. Of all the patients, 86% were men and 92% had hepatitis C virus infection. At the time of liver transplantation, 96% of patients with HIV were undergoing antiretroviral therapy. Median follow-up was 46 months.

Overall, 16% of patients with HIV (n = 12) and 14% of HIV-negative patients (n = 32) developed HCC recurrence. The HCC recurrence rates for both groups were similar at 1, 3 and 5 years. Recurrence rates for HIV-infected patients at 1 year was 7%, 17% at 3 years and 20% at 5 years. In HIV-negative patients, the rate of HCC recurrence at 1 year was 5%, 11% at 3 years and 19% at 5 years.

The survival rate for HIV-infected patients was 87% at 1 year, 78% at 3 years and 69% at 5 years posttransplant. In HIV-negative patients, the survival rate at 1 year was 89%, 78% at 3 years and 73% at 5 years. Microscopic vascular invasion was the only variable independently associated with HCC recurrence (HR = 3.79; 95% CI, 1.67-8.57), whereas HCV and satellite nodules were independently associated with mortality posttransplant.  

“HIV infection did not have any impact on recurrence of HCC or survival after [liver transplantation],” the researchers concluded. “These results support the indication of [liver transplantation] in HIV-infected patients with HCC.” – by Melinda Stevens

Reference:

Agüero FH, et al. Abstract 640.  Presented at: Conference on Retroviruses and Opportunistic Infections; Feb. 23-26, 2015; Seattle.

Disclosure: Relevant financial disclosures were not provided by researchers.