Hospital Muñiz, Liver Diseases, Buenos Aires, Argentina.
Hospital Posadas, Pathology, Buenos Aires, Argentina.
Ann Hepatol. 2013;13(1):38-44.
INTRODUCTION. High activity antiretroviral therapy (HAART) has allowed people infected with human immunodeficiency virus (HIV) to live longer. In the course of time, hepatocellular carcinoma (HCC) began to be found in these patients. Investigations have suggested that, as it has been described for other tumors, HIV infection raises the risk of developing HCC. However, convincing evidence is still required. Our aim was to quantify the incidence of HCC in hepatitis C cirrhotic patients with and without human immunodeficiency virus infection in the HAART era. MATERIAL AND METHOds. This prospective cohort study was conducted in hepatitis C cirrhotic patients with and without HIV co-infection, between june 1, 1999 and May 21, 2010. Ultrasound screening for HCC was performed every 6 to 12 months to all the patients until January 15, 2011. Incidence rate and cumulative incidence (Kaplan-Meier) were calculated. RESULTS. One hundred and forty eight patients (69 hepatitis C virus mono-infected and 79 HIV/hepatitis C virus co-infected) were followed for a median time of 43 months, with a total follow-up of 555 person-years (324 for co-infected and 231 for mono-infected patients). Twelve patients developed HCC (5 co-infected and 7 mono-infected). The incidence of HCC in co-infected patients and mono-infected patients was 1.54 (95% confidence interval = 0.5 to 3.6) and 3.03 (95% confidence interval = 1.22 to 6.23) cases per 100 person-year respectively (log-rank p = 0.3225). CONCLUSION. In the HAART era, HIV co-infection is not associated with a higher incidence of HCC in hepatitis C cirrhotic patients.
简介。高效抗逆转录病毒治疗（HAART）使得感染人类免疫缺陷病毒（HIV）的人能够活得更久。随着时间的推移，这些患者开始出现肝细胞癌（HCC）。研究表明，就像其他肿瘤一样，HIV 感染会增加发生 HCC 的风险。然而，仍需要令人信服的证据。我们的目的是在 HAART 时代，量化丙型肝炎肝硬化患者中合并和不合并 HIV 感染的 HCC 发生率。
材料和方法。这项前瞻性队列研究纳入了 1999 年 6 月 1 日至 2010 年 5 月 21 日期间合并和不合并 HIV 共感染的丙型肝炎肝硬化患者。对所有患者进行每 6 至 12 个月一次的 HCC 超声筛查，直至 2011 年 1 月 15 日。计算发病率和累积发病率（Kaplan-Meier）。
结果。148 例患者（69 例丙型肝炎病毒单感染和 79 例 HIV/丙型肝炎病毒共感染）中位随访时间为 43 个月，总随访时间为 555 人年（共感染患者 324 人年，单感染患者 231 人年）。12 例患者发生 HCC（共感染患者 5 例，单感染患者 7 例）。共感染患者和单感染患者的 HCC 发生率分别为 1.54（95%置信区间=0.5 至 3.6）和 3.03（95%置信区间=1.22 至 6.23）例/100 人年（对数秩检验 p=0.3225）。
结论。在 HAART 时代，HIV 共感染与丙型肝炎肝硬化患者 HCC 发生率的增加无关。
