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The impact of HIV on hepatocellular cancer survival in Nigeria.
- Source :
-
Tropical medicine & international health : TM & IH [Trop Med Int Health] 2021 Mar; Vol. 26 (3), pp. 335-342. Date of Electronic Publication: 2020 Dec 20. - Publication Year :
- 2021
-
Abstract
- Background: Hepatocellular carcinoma (HCC) is an increasing cause of mortality in HIV-infected individuals. We compared host and tumour characteristics between HIV-infected and HIV-uninfected Nigerians with HCC and examined the impact of HIV on survival.<br />Methods: This prospective observational study was conducted at Jos University Teaching Hospital in Jos, Nigeria, among adults (>18 years) with HCC enrolled between September 2015 and September 2017 and followed until April 2019. Demographics, tumour characteristics and survival were compared between HCC subjects with and without HIV.<br />Results: 101 (10 HIV-infected and 91 HIV-uninfected) subjects were enrolled [male 72%; median age 48 (IQR 35-60)]. 60% HIV-infected subjects were receiving ART; 90% had CD4 counts ≥ 200/mm <superscript>3</superscript> at HCC diagnosis, and 20% had HIV RNA levels < 20 copies/mL. 57.4% were infected with chronic HBV (HBsAg+). The duration of symptoms was shorter in HIV-infected vs. HIV-uninfected subjects [93 (IQR 54-132) vs. 155 (93-248] days; p = 0.02]. At the end of follow-up, 99 of 101 (98.0%) subjects were confirmed to have died: 9 of 10 (90.0%) HIV-infected and 90 of 91 (98.9%) HIV-uninfected. The probability of survival at three months was 22% and 47% in HIV-infected and HIV-uninfected subjects, respectively (P = 0.02). Median time to death was significantly shorter in HIV-infected vs. HIV-uninfected subjects [24 days (IQR 16-88) vs. 85 days (IQR 34-178), respectively (P = 0.03)].<br />Conclusions: High early mortality was observed in this cohort of Nigerian adults with HCC. HIV infection was associated with a faster clinical presentation and shorter survival. More aggressive HCC surveillance may be warranted in HIV-infected subjects, particularly if they are co-infected with chronic HBV.<br /> (© 2020 John Wiley & Sons Ltd.)
- Subjects :
- Adult
Cohort Studies
Coinfection
Female
Humans
Male
Middle Aged
Nigeria epidemiology
Prevalence
Prognosis
Prospective Studies
Survival Analysis
Carcinoma, Hepatocellular complications
Carcinoma, Hepatocellular mortality
HIV Infections complications
Hepatitis B complications
Liver Neoplasms complications
Liver Neoplasms mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1365-3156
- Volume :
- 26
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Tropical medicine & international health : TM & IH
- Publication Type :
- Academic Journal
- Accession number :
- 33244817
- Full Text :
- https://doi.org/10.1111/tmi.13532