HIV INFECTION AND SURVIVAL IN PATIENTS WITH HCCAND LIVER CIRRHOSIS

Background and Aims: HCC is an emerging problem for HIVpatients, particularly if HCV and/or HBV co-infected. At the present,few data are available on the effect of HCC treatment receipt in HIV+patients. Our data aim to retrospectively compare survival rates inpatients with and without HIV infection affected by liver cirrhosisand HCC (HCC-LC).Materials and Methods: 65 HIV positive (HIV+) (54 on HAART;34 A1-A3, 17 B1-B3 and 9 C1-C3 stage; 12 with CD4 lowerthan 200) and 267 HIV negative (HIV−) HCC-LC subjects werecompared in terms of survival rates considering age, tumor andliver disease characteristics at the diagnosis (etiology, BCLC stage,number of lesions, vascular invasion, progression), treatment receipt(no treatment, palliative or curative, treatment at the progression),HIV status. All subjects were male and had at least three-months ofdisease follow up.Results: The Table resumes median survival rates according todifferent treatment strategies in the considered groups.Median survival (months) pHIV+ HIV−Overall 31.3±4.91 (n = 65) 59.7±7.07 (n = 267) .010Untreated 4.52±1.83 (n = 6) 36.1±15.2 (n = 48) .000Treated (all treatment) 35.0±11.3 (n = 59) 65.0±7.23 (n = 219) .042Treated (curative) 35.1±11.9 (n = 25) 67.8±14.7 (n = 75) .000Treated (palliative) 31.1±10.2 (n = 34) 53.1±11.1 (n = 144) .052Factors independently related to survival (Cox regression) were:HIVab pos (HR = .567, 95% CI 0.317–0.912, p = 0.046), HCCTreatment (HR = 1.506, 95%–CI 1.154–2.549, p = 0.035), tumor size>5 cm (HR = 1.257, 95% CI 1.106–1.636, p = 0.025) BCLC 0−1(HR = 1.247, 95% CI 1.100–1.576, P = 0.034), such as HAARTtherapy (HR = 2.25, 95% CI 1.01–5.048, p = .048) and treatment atprogression (TaP) (HR = 2.801, 95% CI 1.78–4.56, p = 0.000). HIV−patients had a higher frequency of TaP (88.6% vs. 67.3%, p = 0.001).Conclusions: HIV infection negatively influences HCC outcome,even in treated patients. The role of reduced re-treatment rate in caseof HCC progression in these patients needs be evaluated.