Effective HCC Therapy Obliterates Beneficial Effect of Suppressed HIV Infection on Survival: Presented at AIDS 2010

By Jenny Powers
VIENNA -- July 23, 2010 -- Patients coinfected with hepatitis C virus (HCV) and HIV who have undetectable serum HIV-RNA levels at the time of hepatocellular carcinoma (HCC) diagnosis experience longer survival than patients with detectable HIV-RNA levels.

However, HCC treatment resulted in similar overall survival rates in patients with undetectable and detectable serum HIV-RNA levels.

These were the findings of a study presented on July 21 here at the 18th International AIDS Conference by Emma Page, MD, Liver Cancer in HIV Study Group, Chelsea & Westminster Hospital, London, United Kingdom.

Among the 115 patients analysed in the study, median overall survival was longer in the group with undetectable HIV-RNA (11.7 vs. 4.9 months; P = .007). However, increased survival benefit was seen only in patients with undetectable HIV-RNA who were untreated for HCC (6.4 vs 2.5 months; P = .005).

The median overall survival in patients with any effective HCC therapy was 12.7 months and 9.3 months, in the HIV-RNA undetectable and detectable groups, respectively (P = .74).

Researchers analysed data from 115 patients with HIV and HCC who were seen from 1992 to 2009 in 22 centres throughout North and South America and Europe who had results of HIV-RNA testing available at time of HCC diagnosis.

Plasma HIV-RNA was undetectable (<400 copies/mL) in 68 (58%) patients, and 47 (42%) patients had detectable HIV-RNA levels (>400 copies/mL).

Although patients' characteristics were similar in both groups (92% male; etiology of HCC: HCV 74%, HBV 24%; and alcohol consumption -- excessive in 39%), patients with HCV-RNA <400 copies/mL presented symptoms less frequently (38% vs 55%; P = .070); had lower Child-Turcotte-Pugh (6.4 vs 7.3; P = .007); and had lower Cancer-of-the-Liver-Italian-Program (CLIP) staging scores (1.7 vs 2.4; P = .004).

The authors plan an expanded study with increased sample number to fully characterise these results.

[Presentation title: Improved Survival of Hepatocellular Carcinoma (HCC) in HIV-Infected Patients With Undetectable HIV RNA. Abstract TUPDB106]

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