Liver cancer rates are increasing in those with hepatitis C infections.
Incidence of liver cancer is increasing among people with HIV co-infection, an international team of investigators report in the online edition of Clinical Infectious Diseases. Researchers from Europe and Canada pooled data gathered between 2001 and 2014 from six prospective cohorts and found that incidence of hepatocellular carcinoma (HCC) increased but the incidence of serious liver related events – decompensated liver disease or liver-related death – declined.
“It seems paradoxical that improvements in liver-related morbidity in HIV/HCV co-infected patients, demonstrated by a lower incidence of other events, would simultaneously yield a higher incidence of HCC,” comment the authors. “Perhaps an improved management of liver cirrhosis and HIV treatment can increase the threshold for liver decompensation in the cirrhotic HIV/HCV co-infected individuals, but thus increasing longevity such that viral hepatocarcinogenesis has enough time to manifest itself as HCC.”
Overall, the investigators believe their results support additional surveillance of trends in HCC incidence.
Large numbers of people living with HIV have co-infection with hepatitis C virus (HCV). Chronic HCV infection can lead to serious liver disease, including HCC. HIV co-infection is known to accelerate disease progression. However, the prognosis for people with co-infection has improved significantly in recent years. Some research suggests that the overall incidence of serious liver disease is declining but rates of HCC are increasing in people with co-infection.
Investigators from EuroSIDA, the South Alberta Clinic Cohort, the Canadian Co-infection Cohort and the Swiss HIV Cohort therefore designed a study to determine incidences of HCC and other liver events between 2001 and 2014 and identify the risk factors for liver cancer and serious liver disease/death.
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