Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul 15;37(9):1387-1397.
doi: 10.1097/QAD.0000000000003568. Epub 2023 Apr 5.

Survival outcomes in veterans with hepatocellular carcinoma, with and without HIV infection

Yvonne H Sada  1   2   3 , Wilson L da Costa Jr  3   4 , Jennifer R Kramer  1   5 , Elizabeth Y Chiao  3   6   7 , Efthalia Zafeiropoulou  1 , Yongquan Dong  1 , Liang Chen  1 , Bich N Dang  1   8
Affiliations

Survival outcomes in veterans with hepatocellular carcinoma, with and without HIV infection

Yvonne H Sada et al. AIDS. .

Abstract

Background: HIV infection has been associated with survival disparities among persons with hepatocellular carcinoma (HCC). However, most studies examining survival do not control for provider (e.g. type of HCC treatment given) or individual-level factors (e.g. homelessness, substance use) that could impact survival. In this study, we evaluate the effect of HIV status on survival among persons with HCC, in a comprehensive model that accounts for key individual, provider, and systems-level factors.

Methods: We conducted a retrospective cohort study of persons with HIV (PWH) matched 1 : 1 to HIV-negative controls based on age and year of HCC diagnosis in the national Veterans Administration (VA) health system. The primary outcome was survival. We used Cox regression models to evaluate the effect of HIV status on risk of death.

Results: This cohort included 200 matched pairs diagnosed with HCC between 2009 and 2016. A total of 114 PWH (57.0%) and 115 HIV-negative patients (57.5%) received guideline-concordant therapy ( P = 0.92). Median survival was 13.4 months [95% confidence interval (CI) 8.7-18.1] among PWH and 19.1 months (95% CI 14.6-24.9) for HIV-negative patients. In adjusted models, older age, homelessness, advanced Barcelona Clinic Liver Cancer (BCLC) stage, and not receiving any HCC treatment predicted risk of death. HIV status was not associated with risk of death [adjusted hazard ratio (aHR) 0.95; 95% CI 0.75-1.20; P = 0.65].

Conclusion: HIV status was not associated with worse survival among HCC patients, in a single-payer, equal access healthcare system. These results suggest that HIV infection alone should not exclude PWH from receiving standard therapy.

PubMed Disclaimer

References

    1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries . CA Cancer J Clin 2021; 71:209–249.
    1. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022 . CA Cancer J Clin 2022; 72:7–33.
    1. Sun J, Althoff KN, Jing Y, Horberg MA, Buchacz K, Gill MJ, et al. Trends in hepatocellular carcinoma incidence and risk among persons with HIV in the US and Canada, 1996–2015 . JAMA Netw Open 2021; 4:e2037512.
    1. Otedo A, Simbiri KO, Were V, Ongati O, Estambale BA. Risk factors for liver cancer in HIV endemic areas of Western Kenya . Infect Agent Cancer 2018; 13:41.
    1. McGinnis KA, Fultz SL, Skanderson M, Conigliaro J, Bryant K, Justice AC. Hepatocellular carcinoma and non-Hodgkin's lymphoma: the roles of HIV, hepatitis C infection, and alcohol abuse . J Clin Oncol 2006; 24:5005–5009.

Publication types