期刊
AIDS
卷 32, 期 11, 页码 1423-1430出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QAD.0000000000001809
关键词
hepatitis C virus; hepatocellular carcinoma; HIV; liver cirrhosis; sustained virological response
资金
- Consejeria de Salud de la Junta de Andalucia [PI-0014/2014]
- Servicio Andaluz de Salud [SAS/111239]
- Fondo de Investigaciones Sanitarias ISCIII [PI13/01621, PI16/01443]
- Instituto de Salud Carlos III [Programa-I3SNS]
- Grupo para el Estudio de las Hepatitis Viricas (GEHEP) de la SEIMC (2017 grant) [GEHEP-002]
- SPANISH AIDS Research Network as part of the Plan Nacional R + D + I [RD16/0025/0010]
- ISCIII Subdireccion General de Evaluacion y el Fondo Europeo de Desarrollo Regional (FEDER)
Objective: To assess the possible association between the use of direct antiviral agents (DAA) and the risk of hepatocellular carcinoma (HCC) in HIV/hepatitis C virus (HCV)-coinfected patients. Methods: The GEHEP-002 cohort recruits HCC cases in HIV-infected patients from 32 centers from Spain. Three analyses were performed: the proportion of HCC cases after sustained virological response (SVR) and the evolution of this proportion over time, the frequency of HCC after SVR in HIV/HCV-coinfected patients with cirrhosis, and the probability of HCC recurrence after curative therapies among those undergoing HCV therapy. Results: Forty-two (13%) out of 322 HCC cases in HIV/HCV-coinfected patients occurred after SVR. Twenty-eight (10%) out of 279 HCC cases diagnosed during the years of use of IFN-based regimens occurred after SVR whereas this occurred in 14 (32.6%) out of the 43 HCC cases diagnosed in the all-oral DAA period (P < 0.0001). One thousand, three hundred and thirty-seven HIV/HCV-coinfected patients with cirrhosis achieved SVR in the cohort. The frequency of HCC after SVR declined from 15% among those cured with pegylated-IFN with ribavirin to 1.62 and 0.87% among those cured with DAA with and without IFN, respectively. In patients with previous HCC treated with curative therapies, HCC recurrence occurred in two (25%) out of eight patients treated with IFN-based regimens and four (21%) out of 19 treated with DAA-IFN-free regimens (P = 1.0). Conclusion: The frequency of HCC emergence after SVR has not increased after widespread use of DAA in HIV/HCV-coinfected patients. DAA do not seem to impact on HCC recurrence in the short-term among those with previously treated HCC. Copyright (C) 2018 Wolters Kluwer Health, Inc. All rights reserved.
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