Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.
Trans-Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.
J Natl Cancer Inst. 2024 Jan 10;116(1):61-68. doi: 10.1093/jnci/djad172.
People with HIV have higher risk of hepatocellular carcinoma than the general population, partly because of higher prevalence of coinfection with hepatitis B virus (HBV) or hepatitis C virus (HCV).
We calculated standardized incidence ratios for hepatocellular carcinoma in people with HIV by comparing rates from people with HIV in the HIV/AIDS Cancer Match Study, a population-based HIV and cancer registry linkage, to those in the general population. We used multivariable Poisson regression to estimate adjusted incidence rate ratios among people with HIV and linked the Texas HIV registry with medical claims data to estimate adjusted odds ratios (AORs) of HBV and HCV in hepatocellular carcinoma patients with logistic regression.
Compared with the general population, hepatocellular carcinoma rates in people with HIV were elevated 2.79-fold (n = 1736; 95% confidence interval [CI] = 2.66 to 2.92). Hepatocellular carcinoma rates decreased statistically significantly from 2001-2004 to 2015-2019 (P < .001). Compared with men who have sex with men, hepatocellular carcinoma risk was elevated 4.28-fold among men who injected drugs (95% CI = 3.72 to 4.93) and 1.83-fold among women who injected drugs (95% CI = 1.49 to 2.26). In Texas, 146 hepatocellular carcinoma cases among people with HIV were linked to claims data: 25% HBV positive, 59% HCV positive, and 13% coinfected with HBV and HCV. Compared with men who had sex with men, people who inject drugs had 82% decreased odds of HBV (AOR = 0.18, 95% CI = 0.05 to 0.63) and 2 times the odds of HCV (AOR = 20.4, 95% CI = 3.32 to 125.3).
During 2001-2019, hepatocellular carcinoma risk declined among people with HIV, though rates remain statistically significantly elevated compared with the general population, particularly among people who inject drugs. Prevention and treatment of HBV/HCV are needed to reduce hepatocellular carcinoma risk among people with HIV.
与一般人群相比，HIV 感染者罹患肝细胞癌的风险更高，部分原因是乙型肝炎病毒（HBV）或丙型肝炎病毒（HCV）合并感染更为常见。
我们通过比较艾滋病毒/艾滋病癌症匹配研究（HIV/AIDS Cancer Match Study）中 HIV 感染者的发生率和一般人群的发生率，计算出 HIV 感染者患肝细胞癌的标准化发病比。我们使用多变量泊松回归估计 HIV 感染者的调整发病率比，并将德克萨斯州 HIV 登记处与医疗索赔数据相联系，使用逻辑回归估计肝细胞癌患者中 HBV 和 HCV 的调整优势比（AOR）。
与一般人群相比，HIV 感染者的肝细胞癌发病率高出 2.79 倍（n=1736；95%置信区间[CI] = 2.66 至 2.92）。从 2001-2004 年到 2015-2019 年，肝细胞癌发病率呈统计学显著下降（P<.001）。与男男性行为者相比，男性注射毒品者的肝细胞癌风险高出 4.28 倍（95%CI = 3.72 至 4.93），女性注射毒品者的肝细胞癌风险高出 1.83 倍（95%CI = 1.49 至 2.26）。在德克萨斯州，有 146 例 HIV 感染者的肝细胞癌病例与索赔数据相关联：25%HBV 阳性，59%HCV 阳性，13%HBV 和 HCV 合并感染。与男男性行为者相比，注射毒品者的 HBV 感染可能性降低了 82%（AOR = 0.18，95%CI = 0.05 至 0.63），而 HCV 感染的可能性增加了 2 倍（AOR = 20.4，95%CI = 3.32 至 125.3）。
2001-2019 年期间，HIV 感染者的肝细胞癌风险有所下降，但与一般人群相比，风险仍呈统计学显著升高，尤其是在注射毒品者中。需要预防和治疗 HBV/HCV，以降低 HIV 感染者的肝细胞癌风险。
