Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, China.
Medical Data Analytic Centre, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, China.
Aliment Pharmacol Ther. 2023 Oct;58(8):814-823. doi: 10.1111/apt.17654. Epub 2023 Jul 28.
It is uncertain whether people with HIV infection have a higher incidence of hepatocellular carcinoma (HCC) than the general population.
To compare the incidence of HCC between people infected with HBV and/or HCV with and without HIV METHODS: We performed a retrospective population-based cohort study, involving people with HBV and/or HCV infection from 2001 to 2018. The primary endpoint was incidence of HCC; secondary endpoint was all-cause mortality. We performed Cox proportional hazard regression models to estimate the hazard ratios (HR) of HIV for the primary and secondary endpoints.
We identified 1374 people infected with HIV and 39,908 people without HIV with HBV and/or HCV infection. Among those with HIV, 654 (47.6%) had HBV, 649 (47.2%) HCV and 71 (5.2%) HBV-HCV-co-infection; they were younger, and had a higher prevalence of HCV and a lower prevalence of cirrhosis. The incidence rate estimates of HCC were, respectively, 1.5 (95% CI: 0.8-2.5) and 7.6 (95% CI 7.3-8.0) per 1000 person-years for those with and without HIV infection. Using multivariate Cox proportional hazard regression models, among people with HBV, HIV was associated with lower risk of HCC (adjusted HR: 0.376, 95% CI: 0.201-0.704, p = 0.01) and death (adjusted HR: 0.692, 95% CI: 0.552-0.867, p = 0.007). Risks of HCC were similar for HCV and HBV-HCV co-infection for people with and without HIV.
Among individuals with HBV infection, the Incidence of HCC was lower in those with HIV. For HCV infection, incidence of HCC was similar between those with and without HIV.
目前尚不确定 HIV 感染者的肝细胞癌（HCC）发病率是否高于普通人群。
比较乙型肝炎病毒（HBV）和/或丙型肝炎病毒（HCV）感染合并与不合并 HIV 感染者 HCC 的发病率。
我们进行了一项回顾性基于人群的队列研究，纳入了 2001 年至 2018 年期间的 HBV 和/或 HCV 感染者。主要终点为 HCC 发病率；次要终点为全因死亡率。我们采用 Cox 比例风险回归模型来估计 HIV 对主要和次要终点的危害比（HR）。
我们共纳入了 1374 名感染 HIV 的患者和 39908 名感染 HBV 和/或 HCV 且不合并 HIV 的患者。在 HIV 感染者中，654 例（47.6%）感染 HBV，649 例（47.2%）感染 HCV，71 例（5.2%）合并 HBV 和 HCV 感染；他们更年轻，HCV 感染率更高，肝硬化发生率更低。合并与不合并 HIV 感染者的 HCC 发病率估计值分别为 1.5（95%CI：0.8-2.5）和 7.6（95%CI 7.3-8.0）/1000 人年。采用多变量 Cox 比例风险回归模型，在 HBV 感染者中，HIV 与 HCC 风险降低相关（调整 HR：0.376，95%CI：0.201-0.704，p=0.01）和死亡风险降低相关（调整 HR：0.692，95%CI：0.552-0.867，p=0.007）。合并与不合并 HIV 感染者的 HCV 和 HBV-HCV 合并感染患者的 HCC 风险相似。
在 HBV 感染者中，HIV 感染者的 HCC 发病率较低。对于 HCV 感染，合并与不合并 HIV 感染者的 HCC 发病率相似。
