Scientific publications
Human immunodeficiency virus-infected liver transplant recipients with incidental hepatocellular carcinoma: A prospective multicenter nationwide cohort study
Agüero F (1), Forner A (2,3), Valdivieso A (4), Blanes M (5), Barcena R (6), Manzardo C (1), Rafecas A (7), Castells L (3,8), Abradelo M (9), Barrera-Baena P (3,10), González-Diéguez L (11), Salcedo M (12), Serrano T (13), Jiménez-Pérez M (14), Herrero JI (3,15,16), Gastaca M (4), Aguilera V (3,5), Fabregat J (7), Del Campo S (6), Bilbao I (8), Romero CJ (9), Moreno A (1), Rimola A (3,17), Miro JM (1); FIPSE Investigators.
ABSTRACT
There is a lack of data on incidental hepatocellular carcinoma (iHCC) in the setting of liver transplantation (LT) in human immunodeficiency virus (HIV)-infected patients.
This study aims to describe the frequency, histopathological characteristics, and outcomes of HIV+ LT recipients with iHCC from a Spanish multicenter cohort in comparison with a matched cohort of LT patients without HIV infection.
A total of 15 (6%) out of 271 patients with HIV infection who received LT in Spain from 2002 to 2012 and 38 (5%) out of the 811 HIV- counterparts presented iHCC in liver explants (P = 0.58). Patients with iHCC constitute the present study population. All patients also had hepatitis C virus (HCV)-related cirrhosis.
There were no significant differences in histopathological features of iHCC between the 2 groups. Most patients showed a small number and size of tumoral nodules, and few patients had satellite nodules, microvascular invasion, or poorly differentiated tumors.
After a median follow-up of 49 months, no patient developed hepatocellular carcinoma (HCC) recurrence after LT. HIV+ LT recipients tended to have lower survival than their HIV- counterparts at 1 (73% versus 92%), 3 (67% versus 84%), and 5 years (50% versus 80%; P = 0.06).
There was also a trend to a higher frequency of HCV recurrence as a cause of death in the former (33% versus 10%; P = 0.097). In conclusion, among LT recipients for HCV-related cirrhosis, the incidence and histopathological features of iHCC in HIV+ and HIV- patients were similar. However, post-LT survival was lower in HIV+ patients probably because of a more aggressive HCV recurrence. Liver Transplantation 23 645-651 2017 AASLD.
CITATION Liver Transpl. 2017 May;23(5):645-651. doi: 10.1002/lt.24741
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