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A new study conducted by Spanish
researchers has sounded the alarm that rates of liver cancer are rising
dramatically among people with HIV, solely as a result of coinfection with
either hepatitis B, C or both, aidsmap reports.
Published in the online edition of
Clinical Infectious Diseases, the analysis of records from 18 hospitals in
Spain concerning HIV patients between 1999 to 2010 offered a grim portrait:
Those with hepatocellular carcinoma (HCC, the most common liver cancer) were
often diagnosed late and had generally poor prognoses; and less than a third of
the liver cancer patients coinfected with the hepatitis C virus (HCV) ever
received antiviral treatment.
The researchers identified 82 cases
of liver cancer in people with HIV, all of them among people coinfected with
viral hepatitis. Sixty-six people (81 percent of the cases) had hepatitis C; 6
people (7 percent) were coinfected with hepatitis B; and 10 people (12 percent)
had both hep B and C. Only 22 (29 percent) of the hep C patients had received
antiviral therapy for the virus; among that group, six had achieved a sustained
virologic response (SVR, considered a cure). (A recent study
[http://www.hepmag.com/articles/HM_Liver_Cancer_2502_23119.shtml] found that
antiviral therapy reduces rates of liver cancer among people with hepatitis C,
irrespective of reaching an SVR, although researchers could not determine
whether the benefits of therapy merely delayed the onset of liver cancer.)
Those who received antiviral therapy had a mortality rate of 29 percent
compared with a rate of 87 percent for those who did not.
The scientists found that incidence
of liver cancer spiked 14-fold between 2000 and 2009. They theorized that the
dramatic increase was a consequence of four factors: coinfected patients are
living longer thanks to HIV therapies, giving liver cancer more time to
develop; hep C therapies do not work as well in HIV-positive people; HIV may
speed the course of hepatitis C-related disease; and the improved clinical care
for liver cirrhosis has also extended the lives of coinfected patients, giving
cancer more time to develop.
The study authors called on
clinicians to remain vigilant for liver cancer among their coinfected patients
and to perform routine ultrasound exams to screen for the disease, even among
those who have been cured of hepatitis C.
The Friends of AIDS Foundation is
dedicated to enhancing the quality of life for HIV positive individuals and
empowering people to make healthy choices to prevent the spread of the HIV
virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.
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