Survival outcomes in veterans with hepatocellular carcinoma, with and without HIV infection.
Survival outcomes in veterans with hepatocellular carcinoma, with and without HIV infection.
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患有肝细胞癌的退伍军人（无论是否感染艾滋病毒）的生存结果。
DOI：
10.1097/qad.0000000000003568
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Dang,BichN
中科院分区：
文献类型：
--
作者：
Sada,YvonneH;daCostaJr,WilsonL;Kramer,JenniferR;Chiao,ElizabethY;Zafeiropoulou,Efthalia;Dong,Yongquan;Chen,Liang;Dang,BichN
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 (eg type of HCC treatment given) or individual-level factors (eg 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.BackgroundHepatocellular carcinoma (HCC) is a leading cause of cancer-related death in the world and the United States [1, 2]. It is also one of the most common non-AIDS defining cancers in persons with HIV (PWH). The risk of HCC is four-times higher in PWH than in persons without HIV infection. Among PWH, the incidence rates of HCC are five to 10 times higher among those with hepatitis B virus (HBV) or hepatitis C virus (HCV) co-infection [3–6]. Furthermore, HCC has one of the lowest cancer survival rates among PWH, with almost all studies showing worse HCC survival among PWH compared with HIV-negative persons [6–12].
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影响因子：
2.5
作者：
Rosenthal, E.;Pialoux, G.;Cacoub, P.
通讯作者：
Cacoub, P.
DOI：
10.1016/j.clinre.2011.11.002
发表时间：
2012-06-01
影响因子：
2.7
作者：
Bourcier, Valerie;Winnock, Maria;Salmon, Dominique
通讯作者：
Salmon, Dominique
影响因子：
2.9
作者：
Singal, Amit G.;Volk, Michael L.;Marrero, Jorge A.
通讯作者：
Marrero, Jorge A.
影响因子：
25.7
作者：
Braeu, Norbert;Fox, Rena K.;Bini, Edmund J.
通讯作者：
Bini, Edmund J.
影响因子：
39.2
作者：
Patel, Pragna;Hanson, Debra L.;Brooks, John T.
通讯作者：
Brooks, John T.