Trends in Hepatocellular Carcinoma Incidence and Risk Among Persons With HIV in the US and Canada, 1996-2015

Key Points Question Has the incidence rate or risk for liver cancer among people with HIV increased with the widespread availability of combination antiretroviral therapy? Findings In this cohort study of 109 283 people with HIV in North America, the incidence rate of liver cancer increased between the early and modern combination antiretroviral therapy eras. People with HIV coinfected with hepatitis B virus and/or hepatitis C virus, those with higher HIV RNA levels and lower CD4 cell counts, and persons who inject drugs had a higher liver cancer risk. Meaning These findings underscore the importance of achieving immune recovery along with monitoring for and long-term management of viral hepatitis among people with HIV.

[1]  Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV , 2020 .

[2]  Richard D Moore,et al.  Determinants of Liver Complications Among HIV/Hepatitis B Virus-Coinfected Patients , 2019, Journal of acquired immune deficiency syndromes.

[3]  T. O'Brien,et al.  Incidence of hepatocellular carcinoma among older Americans attributable to hepatitis C and hepatitis B: 2001 through 2013 , 2019, Cancer.

[4]  David L. Thomas.  Global Elimination of Chronic Hepatitis. , 2019, The New England journal of medicine.

[5]  M. Abecassis,et al.  Diagnosis, Staging, and Management of Hepatocellular Carcinoma: 2018 Practice Guidance by the American Association for the Study of Liver Diseases , 2019, Clinical Liver Disease.

[6]  Jiaquan Xu.  Trends in Liver Cancer Mortality Among Adults Aged 25 and Over in the United States, 2000-2016. , 2018, NCHS data brief.

[7]  U. Spengler.  Direct antiviral agents (DAAs) ‐ A new age in the treatment of hepatitis C virus infection , 2017, Pharmacology & therapeutics.

[8]  F. Bray,et al.  Projections of primary liver cancer to 2030 in 30 countries worldwide , 2018, Hepatology.

[9]  Alan D. Lopez,et al.  The Burden of Primary Liver Cancer and Underlying Etiologies From 1990 to 2015 at the Global, Regional, and National Level , 2017, JAMA oncology.

[10]  R. Sterling,et al.  Mechanisms of liver disease in patients infected with HIV , 2017, BMJ open gastroenterology.

[11]  S. Lewin,et al.  HIV-hepatitis B virus coinfection: epidemiology, pathogenesis, and treatment , 2017, AIDS.

[12]  Jeesun Jung,et al.  Prevalence of 12-Month Alcohol Use, High-Risk Drinking, and DSM-IV Alcohol Use Disorder in the United States, 2001-2002 to 2012-2013: Results From the National Epidemiologic Survey on Alcohol and Related Conditions , 2017, JAMA psychiatry.

[13]  Richard D Moore,et al.  Risk of End-Stage Liver Disease in HIV-Viral Hepatitis Coinfected Persons in North America From the Early to Modern Antiretroviral Therapy Eras. , 2016, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[14]  D. Serraino,et al.  Non–AIDS-Defining Cancer Mortality: Emerging Patterns in the Late HAART Era , 2016, Journal of acquired immune deficiency syndromes.

[15]  A. Mocroft,et al.  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. , 2016, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[16]  A. Justice,et al.  Time trends in cancer incidence in persons living with HIV/AIDS in the antiretroviral therapy era: 1997–2012 , 2016, AIDS.

[17]  H. Katki,et al.  Cancer risk among the HIV-infected elderly in the United States , 2016, AIDS.

[18]  K. Crothers,et al.  Prevalence of non-HIV cancer risk factors in persons living with HIV/AIDS: a meta-analysis , 2016, AIDS.

[19]  G. Casazza,et al.  The long-term benefits of nucleos(t)ide analogs in compensated HBV cirrhotic patients with no or small esophageal varices: A 12-year prospective cohort study. , 2015, Journal of hepatology.

[20]  T. Therneau,et al.  Impact of long‐term tenofovir disoproxil fumarate on incidence of hepatocellular carcinoma in patients with chronic hepatitis B , 2015, Cancer.

[21]  Richard D Moore,et al.  Cumulative Incidence of Cancer Among Persons With HIV in North America: A Cohort Study. , 2015, Annals of internal medicine.

[22]  A. Mocroft,et al.  Liver-related death among HIV/hepatitis C virus-co-infected individuals: implications for the era of directly acting antivirals , 2015, AIDS.

[23]  P. Morlat,et al.  Liver‐related deaths in HIV‐infected patients between 1995 and 2010 in France: the Mortavic 2010 study in collaboration with the Agence Nationale de Recherche sur le SIDA (ANRS) EN 20 Mortalité 2010 survey , 2015, HIV medicine.

[24]  J. Kramer,et al.  The Effect of HIV Viral Control on the Incidence of Hepatocellular Carcinoma in Veterans With Hepatitis C and HIV Coinfection , 2015, Journal of acquired immune deficiency syndromes.

[25]  R. Pfeiffer,et al.  Excess cancers among HIV-infected people in the United States. , 2015, Journal of the National Cancer Institute.

[26]  J. Everhart,et al.  Fatty liver indices in the multiethnic United States National Health and Nutrition Examination Survey , 2015, Alimentary pharmacology & therapeutics.

[27]  R. Thimme,et al.  Natural history of chronic hepatitis B virus infection , 2015, Medical Microbiology and Immunology.

[28]  G. Dusheiko,et al.  Natural history of hepatitis C. , 2014, Journal of hepatology.

[29]  O. Baser,et al.  Hepatic decompensation in patients with HIV/Hepatitis B Virus (HBV)/Hepatitis C Virus (HCV) triple infection versus HIV/HCV coinfection and the effect of anti-HBV nucleos(t)ide therapy. , 2014, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[30]  S. Lewin,et al.  The end of AIDS: HIV infection as a chronic disease , 2013, The Lancet.

[31]  R. Westergaard,et al.  Longitudinal changes in engagement in care and viral suppression for HIV-infected injection drug users , 2013, AIDS.

[32]  D. Church,et al.  An epidemiologic update on hepatitis C infection in persons living with or at risk of HIV infection. , 2013, The Journal of infectious diseases.

[33]  G. Dore,et al.  Breaking down the barriers to hepatitis C virus (HCV) treatment among individuals with HCV/HIV coinfection: action required at the system, provider, and patient levels. , 2013, The Journal of infectious diseases.

[34]  J. Pineda,et al.  Increasing incidence of hepatocellular carcinoma in HIV-infected patients in Spain. , 2013, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[35]  A. Rieger,et al.  Five‐year on‐treatment efficacy of lamivudine‐, tenofovir‐ and tenofovir + emtricitabine‐based HAART in HBV–HIV‐coinfected patients , 2012, Journal of viral hepatitis.

[36]  Richard D Moore,et al.  U.S. Trends in Antiretroviral Therapy Use, HIV RNA Plasma Viral Loads, and CD4 T-Lymphocyte Cell Counts Among HIV-Infected Persons, 2000 to 2008 , 2012, Annals of Internal Medicine.

[37]  A. Justice,et al.  HIV infection, aging, and immune function: implications for cancer risk and prevention , 2012, Current opinion in oncology.

[38]  D. Jamieson,et al.  HIV-HBV coinfection--a global challenge. , 2012, The New England journal of medicine.

[39]  J. Goedert,et al.  Cancer burden in the HIV-infected population in the United States. , 2011, Journal of the National Cancer Institute.

[40]  C. Thio.  Hepatitis B and human immunodeficiency virus coinfection , 2009, Hepatology.

[41]  David L. Thomas,et al.  The challenge of hepatitis C in the HIV-infected person. , 2008, Annual review of medicine.

[42]  S. Pol,et al.  FIB‐4: An inexpensive and accurate marker of fibrosis in HCV infection. comparison with liver biopsy and fibrotest , 2007, Hepatology.

[43]  Richard D Moore,et al.  Cohort profile: the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD). , 2007, International journal of epidemiology.

[44]  B. McGovern,et al.  The impact of cirrhosis on CD4+ T cell counts in HIV-seronegative patients. , 2007, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[45]  Richard D Moore,et al.  Hazardous Alcohol Use: A Risk Factor for Non-Adherence and Lack of Suppression in HIV Infection , 2006, Journal of acquired immune deficiency syndromes.

[46]  E. Feuer,et al.  SEER Cancer Statistics Review, 1975-2003 , 2006 .

[47]  J. Rodríguez-Orengo,et al.  Slower fibrosis progression in HIV/HCV-coinfected patients with successful HIV suppression using antiretroviral therapy. , 2006, Journal of hepatology.

[48]  M. Alter,et al.  Epidemiology of viral hepatitis and HIV co-infection. , 2006, Journal of hepatology.

[49]  P. Morlat,et al.  Liver disease as a major cause of death among HIV infected patients: role of hepatitis C and B viruses and alcohol. , 2005, Journal of hepatology.

[50]  Giorgio Palù,et al.  Short statement of the first European Consensus Conference on the treatment of chronic hepatitis B and C in HIV co-infected patients. , 2005, Journal of hepatology.

[51]  M. Riera,et al.  Increased incidence of hepatocellular carcinoma (HCC) in HIV-1 infected patients. , 2005, European journal of internal medicine.

[52]  S. Belle,et al.  Impact of human immunodeficiency virus infection on progression to end-stage liver disease in individuals with hemophilia and hepatitis C virus infection. , 2001, The Journal of infectious diseases.

[53]  J. J. Henning,et al.  Guidelines for the Use of Antiretroviral Agents in HIV-Infected Adults and Adolescents, January 28, 2000 , 1998, HIV clinical trials.

[54]  R. W. Mccollum.  The natural history of hepatitis. , 1969, Bulletin of the New York Academy of Medicine.