Department of Medical Oncology, Democritus University of Thrace, 68100 Thrace, Alexandroupolis, Dragana, Greece.
Med Oncol. 2011 Dec;28 Suppl 1:S165-8. doi: 10.1007/s12032-010-9669-y. Epub 2010 Aug 31.
A significant proportion of HIV patients, ranging between 5-67%, are co-infected with hepatitis B virus (HBV). Several studies suggest an increasing incidence of hepatocellular carcinoma (HCC) in HIV infected individuals. We report the case of a 69 years old male co infected with HBV and HIV who developed HCC. The patient was unfit for curative approach and he underwent three sessions of transcatheter arterial chemoembolisation (TACE). After the last session the disease assessment showed progression and sorafenib therapy was initiated. Highly active antiretroviral therapy (HAART) was continued during sorafenib treatment. The patient achieved a radiological complete response (CR) after 6 months of therapy and remained with no sign of HCC progression at subsequent assessment. Meanwhile, patient's HIV and HBV infections remained stable. Regarding toxicity the patient developed grade 3 hand foot skin reaction (HFSR) that required 50% dose reduction of sorafenib, grade 3 hypertension and grade 2 diarrhea. In conclusion this is the first case of successful treatment of HCC in a HIV-HBV co-infected patient and only the second report of the co administration of sorafenib with HAART.
相当比例的 HIV 患者（5-67%）同时感染乙型肝炎病毒（HBV）。多项研究表明，HIV 感染者中肝细胞癌（HCC）的发病率正在上升。我们报告了一例同时感染 HBV 和 HIV 的 69 岁男性患者，他患有 HCC。该患者不适合进行根治性治疗，因此接受了三次经导管动脉化疗栓塞术（TACE）。最后一次治疗后，疾病评估显示病情进展，开始使用索拉非尼治疗。在索拉非尼治疗期间继续进行高效抗逆转录病毒治疗（HAART）。经过 6 个月的治疗，患者获得了完全的影像学缓解（CR），随后的评估中未发现 HCC 进展的迹象。同时，患者的 HIV 和 HBV 感染仍然稳定。关于毒性，患者出现了 3 级手足皮肤反应（HFSR），需要将索拉非尼的剂量减少 50%，还出现了 3 级高血压和 2 级腹泻。总之，这是首例成功治疗 HIV-HBV 合并感染患者 HCC 的病例，也是首例报告索拉非尼联合 HAART 治疗的病例。
