First-time use of bevacizumab for metastatic hepatocellular carcinoma in a HIV/HBV coinfected patient. A case report

A case of a HIV-1 infected patient with history of chronic hepatitis B and chronic alcohol use without cirrhosis, who presented with aggressive hepatocellular carcinoma (HCC) with multiple metastasis is presented. Systemic chemotherapy combined with use of bevacizumab (anti-VEGF monoclonal antibody) was without effect and the patient succumbed to his disease within weeks. Relatively recent data indicate that HCC may be extremely aggressive in HIV/HBV or HIV/HCV coinfected patients with younger age at presentation, shorter evolution time, a more advanced stage at presentation with higher rates of extrahepatic-extranodal metastases and, finally, a reduced survival rate as compared with HIV-negative patients. To our knowledge, this is the first report in the English literature of bevacizumab use for metastatic hepatocellular carcinoma in HIV infected patients