Trends in incidences and risk factors for hepatocellular carcinoma and other liver events in HIV and hepatitis C Virus–coinfected individuals from 2001 to 2014: a multicohort study Clinical Infectious Diseases
Gjærde et al. aimed to study HIV/HCV–coinfected individuals in Europe and Canada and to describe the epidemiology of hepatocellular carcinoma (HCC) and other liver events in a multicohort collaboration of HIV/HCV–coinfected individuals. From 2001 to 2014, 72 cases of HCC and 375 cases of other liver events occurred, resulting in overall incidence rates of 1.6 cases of HCC per 1000 person-years of follow-up (PYFU) and 8.6 cases of other liver events per 1000 PYFU. From 2001 to 2014 HCC increased from 0.4 to 2.3 cases per 1000 PYFU, whereas other liver events decreased from 9.9 to 5.2 cases per 1000 PYFU. Older age, cirrhosis, and lower current CD4 cell count were independent risk factors for both HCC and other liver events. There was no impact of alcohol abuse, diabetes mellitus, or detectable HIV RNA on the incidence of HCC.
The authors conclude that treatment with direct-acting antivirals and earlier HIV treatment will likely reduce the rates of HCC and other liver events. However, as HCC can develop after sustained virologic response is achieved, or as a consequence of other hepatotoxic exposures, continuous surveillance of incidence trends is needed.