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. 2023 Oct;58(8):814-823.
doi: 10.1111/apt.17654. Epub 2023 Jul 28.

Incidence of hepatocellular carcinoma and mortality in chronic viral hepatitis in an Asian population with and without HIV infection

Grace Chung-Yan Lui  1 , Vicki Wing-Ki Hui  1   2 , Shun-Fung Sze  3 , Bonnie Chun-Kwan Wong  4 , Catherine Cheung  1 , Man-Po Lee  3 , Terry Cheuk-Fung Yip  1   2 , Yee-Kit Tse  1   2 , Jimmy Che-To Lai  1   2 , Henry Lik-Yuen Chan  2   5 , Vincent Wai-Sun Wong  1   2 , Yee-Tak Hui  3 , Grace Lai-Hung Wong  1   2
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Incidence of hepatocellular carcinoma and mortality in chronic viral hepatitis in an Asian population with and without HIV infection

Grace Chung-Yan Lui et al. Aliment Pharmacol Ther. 2023 Oct.

Abstract

Background: It is uncertain whether people with HIV infection have a higher incidence of hepatocellular carcinoma (HCC) than the general population.

Aims: To compare the incidence of HCC between people infected with HBV and/or HCV with and without HIV METHODS: We performed a retrospective population-based cohort study, involving people with HBV and/or HCV infection from 2001 to 2018. The primary endpoint was incidence of HCC; secondary endpoint was all-cause mortality. We performed Cox proportional hazard regression models to estimate the hazard ratios (HR) of HIV for the primary and secondary endpoints.

Results: We identified 1374 people infected with HIV and 39,908 people without HIV with HBV and/or HCV infection. Among those with HIV, 654 (47.6%) had HBV, 649 (47.2%) HCV and 71 (5.2%) HBV-HCV-co-infection; they were younger, and had a higher prevalence of HCV and a lower prevalence of cirrhosis. The incidence rate estimates of HCC were, respectively, 1.5 (95% CI: 0.8-2.5) and 7.6 (95% CI 7.3-8.0) per 1000 person-years for those with and without HIV infection. Using multivariate Cox proportional hazard regression models, among people with HBV, HIV was associated with lower risk of HCC (adjusted HR: 0.376, 95% CI: 0.201-0.704, p = 0.01) and death (adjusted HR: 0.692, 95% CI: 0.552-0.867, p = 0.007). Risks of HCC were similar for HCV and HBV-HCV co-infection for people with and without HIV.

Conclusions: Among individuals with HBV infection, the Incidence of HCC was lower in those with HIV. For HCV infection, incidence of HCC was similar between those with and without HIV.

Keywords: antiviral treatment; cirrhosis; death; liver cancer.

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References

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