Objective: Hepatocellular carcinoma (HCC) is an increasing cause of mortality in
HIV-seropositive individuals. The aim of the study was to compare the main features of
HCC in HIV-seropositive individuals with those in to HIV-negative patients.
Patients and methods: All HIV-infected subjects with a diagnosis of HCC included in
three cancer registry databases were enrolled in the study as cases. HCC cases that
occurred in the province of Brescia, North Italy, in the period 1995–1998 and all
cases reported at the Italian Liver Cancer Project were enrolled as controls. All data
were collected using a standardized case report form. The main clinical and epidemiological
characteristics of patients with HCC and their survival were compared
between HIV-positive and uninfected subjects.
Results: Forty-one HIV-infected subjects with HCC were identified. Multivariate
analysis adjusted for age and sex identified an association between HIV infection and
HCV infection [odds ratio (OR), 11; P ¼ 0.005], and infiltrating tumours and/or
extranodal metastasis at presentation (OR ¼ 11.8; P , 0.001). HIV infection was
independently associated with shorter survival (hazard ratio, 1.63; P ¼ 0.015).
Conclusions: HCC in HIV-infected patients is mainly associated with underlying
chronic hepatitis C and has a more aggressive clinical course. Thus, preventative
strategies (including the treatment of hepatitis C) should be implemented in the
management of HIV/HCV-coinfected patients