4.5 Article

Human immunodeficiency virus-infected liver transplant recipients with incidental hepatocellular carcinoma: A prospective multicenter nationwide cohort study

Journal

LIVER TRANSPLANTATION
Volume 23, Issue 5, Pages 645-651

Publisher

WILEY
DOI: 10.1002/lt.24741

Keywords

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Funding

  1. Spanish Foundation for AIDS Research and Prevention (FIPSE, Madrid, Spain) [TOH-VIH/05, TOH-VIH/08, TOH-VIH/12, TOHVIH/13, TOH-VIH/14]
  2. Spanish Ministry of Health (Madrid, Spain
  3. Investigacion Clinica Independiente grant) [EC11-150]
  4. Instituto de Salud Carlos III
  5. Ministerio de Economia y Competitividad (Madrid, Spain) [CM12/00195, INT15/00168, PI13/01229, PI13/01770]

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There is a lack of data on incidental hepatocellular carcinoma (iHCC) in the setting of liver transplantation (LT) in human immunodeficiency virus (HIV)-infected patients. This study aims to describe the frequency, histopathological characteristics, and outcomes of HIV+ LT recipients with iHCC from a Spanish multicenter cohort in comparison with a matched cohort of LT patients without HIV infection. A total of 15 (6%) out of 271 patients with HIV infection who received LT in Spain from 2002 to 2012 and 38 (5%) out of the 811 HIV- counterparts presented iHCC in liver explants (P = 0.58). Patients with iHCC constitute the present study population. All patients also had hepatitis C virus (HCV)-related cirrhosis. There were no significant differences in histopathological features of iHCC between the 2 groups. Most patients showed a small number and size of tumoral nodules, and few patients had satellite nodules, microvascular invasion, or poorly differentiated tumors. After a median follow-up of 49 months, no patient developed hepatocellular carcinoma (HCC) recurrence after LT. HIV+ LT recipients tended to have lower survival than their HIV- counterparts at 1 (73% versus 92%), 3 (67% versus 84%), and 5 years (50% versus 80%; P = 0.06). There was also a trend to a higher frequency of HCV recurrence as a cause of death in the former (33% versus 10%; P = 0.097). In conclusion, among LT recipients for HCV-related cirrhosis, the incidence and histopathological features of iHCC in HIV+ and HIV- patients were similar. However, post-LT survival was lower in HIV+ patients probably because of a more aggressive HCV recurrence. Liver Transplantation 23 645-651 2017 AASLD.

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