Prevalence of Hepatocellular Carcinoma in HIV Patients Co-infected or Triple Infected With Hepatitis B and Hepatitis C in a Community Hospital in South Bronx

Abstract

Background Human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) share common modes of transmission; hence HBV and HCV infection are more prevalent among HIV patients. The co-infection with HIV/HBV, HIV/HCV, or HIV/HBV/HCV carries significant morbidity, with higher progression rates to end-stage liver disease or hepatocellular carcinoma (HCC). Methods We conducted a retrospective study among HIV adult patients co-infected with HBV or HCV and those with HCV, HIV, and HBV triple infection enrolled in the outpatient clinic of BronxCare Hospital between the years 2010 and 2021. Records were reviewed to obtain demographic data, including age and sex, hepatitis B surface antigen (HBsAg), anti-HCV antibodies, and CD4 T-lymphocyte count test results. Male and female patients ≥18 years with confirmed HIV by double enzyme-linked immunoassay (ELISA) and western blot, who underwent serology testing for both HBsAg and anti-HCV, were included in the study. Results In this study, 11355 HIV patients were included, comprising 7020 (61.8%) males and 4335 (38.2%) females. A total of 410 (3.6%) were hepatitis B positive, 1432 (12.6%) were hepatitis C positive, and 127 (1.1%) were both hepatitis B and C positive. Fifty-two (0.5%) patients were diagnosed with HCC. The majority of the patient with HCC (50%, n =26) were hepatitis C serology positive (p<0.001) while 9.6% (n=5) were positive for both hepatitis C and hepatitis B (p<0.001). Conclusion HIV/HBV/HCV triple-infected patients had a lower rate of HCC compared to HIV/HCV co-infected patients. HIV without hepatitis C or hepatitis B is an independent risk factor for HCC.

Contagious order as a risk factor for liver fibrosis progression in co-infection with human immunodeficiency virus, hepatitis B and C viruses

“…У этих пациентов обычно ухудшается прогноз и сокращается продолжительность жизни, причем у значительной части пациентов с коинфекцией ВИЧ/ВГВ или ВИЧ/ВГС ускоряется наступление терминальной стадии заболевания печени или развитие гепатоцеллюлярной карциномы по сравнению с лицами, страдающими моноинфекцией в виде хронического гепатита В или С [2,3,4]. Однако, несмотря на обширные данные литературы, посвященные медицинскому значению проблемы коинфекций ВИЧ/ВГВ или ВИЧ/ВГС, мало что известно об исходах, прогнозе и лечении тройной инфекции ВИЧ, ВГВ и ВГС [5].…”

Concordance of Cancer-Associated Cytokines and Mitochondrial DNA Deletion Mutations between Individuals with Hepatocellular Carcinoma and People Living with HIV

“…HCC is on the rise among PLWH with an estimated 72% increase in incidence rate and a higher risk among PLWH aged 50 years or older 7 . A recent retrospective study in the USA and Canada estimated the prevalence of HCC between 0.1 to 0.5% in PLWH 7,8 . However, other studies conducted within HIV endemic regions in South Africa, Uganda, and Kenya estimated a prevalence of 18 to 22% showing the enormous burden of HCC cases in PLWH in Sub-Saharan Africa [9][10][11] .…”

“…HBV and HCV infections are more predominant in PLWH 13 . Moreover, PLWH with HBV and/or HCV coinfections have a rapid progression to end-stage liver disease compared to individuals with HBV and HCV monoinfections 8,14 . These viruses establish chronic infections and the host immune response to curtail the infection leads to the persistent production of cytokines 15 .…”