Hepatocellular carcinoma in HIV hepatitis C virus

Puoti, Massimoa; Rossotti, Robertoa; Garlaschelli, Annalisaa; Bruno, Raffaeleb

doi: 10.1097/COH.0b013e32834bd2b7
HIV and hepatitis C coinfection: Edited by Jurgen Rockstroh and Gail Matthews

Purpose of review: Recent data showed that in some settings with adequate resources liver diseases rank first among the causes of death in persons living with HIV (PLHIV). Although liver decompensation is the first cause of hepatic death in PLHIV, hepatocellular carcinoma (HCC) is also emerging as one of the causes of hepatic death in PLHIV. This review analyzes the main data published on HCC in PLHIV in the last 3 years.

Recent findings: HCC is more common in persons living with HIV than in general population. In PLHIV with a late diagnosis of HCC, less treatable cases and lower survival were described in retrospective studies. New treatment strategies are available for advanced HCC but there are few data available on PLHIV and some open issues. Nevertheless, screening of HIV-infected patients suspected to have cirrhosis seems to be useful and is mandatory in PLHIV and hepatitis C virus (HCV) induced cirrhosis. Together with screening of patients at risk and an early diagnosis, aggressive treatment of the neoplasia including treatment of relapses and maintenance of HIV suppression are the best management strategies for HCC in PLHIV. The role of liver transplantation remains controversial.

Summary: In the last years, HCC is becoming an important issue in PLHIV. Prevention, screening, and treatment strategies for HCC need to be included in the management of PLHIV.

aDepartment of Infectious Diseases, AO Ospedale Niguarda Ca’ Granda, Milano

bDepartment of Infectious and Tropical Diseases, University of Pavia, Pavia, Italy

Correspondence to Massimo Puoti, Department of Infectious Diseases, AO Ospedale Niguarda Ca’ Granda, Piazza Ospedale Maggiore 3, 20162 Milano, Italy Tel: +39 0264442189; fax: +39 0264442681; e-mail: massimopuoti@libero.it

© 2011 Lippincott Williams & Wilkins, Inc.