Abstract
Hepatocellular carcinoma (HCC) is a primary tumor of the liver that arises from hepatocytes. The principal factors that increase the risk of HCC include infection with hepatitis B virus (HBV), infection with hepatitis C virus (HCV), alcoholism, and aflatoxin. Patients with HIV infection also have an increased risk of HCC, but the role of HIV and immunosuppression is unclear, and much of this risk appears to be because of co-infection with HBV and/or HCV. Whether HIV plays a direct role in HCC pathogenesis remains to be established, but it can increase the risk of HCC in individuals co-infected with HBV and/or HCV. The clinical course of HCC depends on stage of cancer disease, performance status, and comorbidities. Therapeutic options include liver transplantation, local antiblastic chemotherapy, and biological agents. In the HIV setting few data are available about treatment options. The increased longevity of patients with HIV appears to be contributing to an increased incidence of HCC in this population and imposes new strategies for prevention and therapeutic management of patients.
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References
Berretta M, Di Benedetto F, Dal Maso L, Cacopardo B, Nasti G, Facchini G, Bearz A, Spina M, Garlassi E, De Re V, Fiorica F, Lleshi A, Tirelli U. Sorafenib for the treatment of unresectable hepatocellular carcinoma in HIV-positive patients. Anticancer Drugs. 2013;24:212–8.
Berretta M, Garlassi E, Cacopardo B, Cappellani A, Guaraldi G, Cocchi S, De Paoli P, Lleshi A, Izzi I, Torresin A, Di Gangi P, Pietrangelo A, Ferrari M, Bearz A, Berretta S, Nasti G, Di Benedetto F, Balestreri L, Tirelli U, Ventura P. Hepatocellular carcinoma in HIV-infected patients: check early, treat hard. Onocologist. 2011;16:1258–69.
Bonnet F, Lewden C, May T, Heripret L, Jougla E, Bevilacqua S, Costagliola D, Salmon D, Chene G, Morlat P. Malignancy-related causes of death in human immunodeficiency virus infected patients in the era of highly active antiretroviral therapy. Cancer. 2004;101:317–24.
Centers for Disease Control and Prevention. 1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMWR Recomm Rep 1992;41(RR-17): 1–19.
Dal Maso L, Polesel J, Serraino D, Lise M, Piselli P, Falcini F, Cancer and AIDS Registries Linkage (CARL) Study. Pattern of cancer risk in persons with AIDS in Italy in the HAART era. Br J Cancer. 2009;100:840–7.
Di Benedetto F, Berretta M, De Ruvo N, Tarantino G, D’amico G, Ballarin R, Iemmolo RM, Gerunda GE. Is advanced hepatocellular carcinoma amenable of cure by liver transplantation with sorafenib as a neoadjuvant approach plus m-TOR inhibitors monotherapy? J Surg Oncol. 2012;105:111–2.
Di Benedetto F, De Ruvo N, Berretta M, Masetti M, Montalti R, Di Sandro S, Ballarin R, Codeluppi M, Guaraldi G, Gerunda GE. Hepatocellular carcinoma in HIV patients treated by liver transplantation. Eur J Surg Oncol. 2008a;34:422–7.
Di Benedetto F, Di Sandro S, De Ruvo N, Berretta M, Montalti R, Guerrini G. Human immunodeficiency virus and liver transplantation: our point of view. Transplant Proc. 2008b;40:1965–71.
Dubrow R, Silverberg MJ, Park LS, Crothers K, Justice AC. HIV infection, aging, and immune function: implications for cancer risk and prevention. Curr Opin Oncol. 2012;24(5):506–16.
Ettorre G, Vennarecci G, Boschetto A, Giovannelli L, Antonini M, Carboni F. Resection and transplantation: evaluation of surgical perspectives in HIV positive patients affected by endstage liver disease. J Exp Clin Cancer Res. 2003;22:S167–9.
Konopnicki D, Mocroft A, De Wit S, Antunes F, Ledergerber B, Katlama C, Zilmer K, Vella S, Kirk O, Lundgren JD. EuroSIDA group Hepatitis B and HIV: prevalence, AIDS progression, response to highly active antiretroviral therapy and increased mortality in the EuroSIDA cohort. AIDS. 2005;19:593–601.
Meijide H, Mena A, Pernas B, Castro A, López S, Vázquez P, Bello L, Baliñas J, RodrÃguez-MartÃnez G, Pedreira JD. Malignancies in HIV-infected patients: descriptive study of 129 cases between 1993 and 2010. Rev Chilena Infectol. 2013;30(2):156–61.
Nunnari G, Leto D, Sullivan J, Xu Y, Mehlman K, Kulkosky J. Seminal reservoirs during an HIV type 1 eradication trial. AIDS Res Hum Retroviruses. 2005;21:768–75.
Pantanowitz L, Schlecht HP, Dezube BJ. The growing problem of non-AIDS-defining malignancies in HIV. Curr Opin Oncol. 2006;18:469–78.
Polesel J, Franceschi S, Suligoi B, Crocetti E, Falcini F, Guzzinati S, Vercelli M, Zanetti R, Tagliabue G, Russo A, Luminari S, Stracci F, De Lisi V, Ferretti S, Mangone L, Budroni M, Limina R, Piffer S, Serraino D, Bellù F, Giacomin A, Donato A, Madeddu A, Vitarelli S, Fusco M, Tessandori R, Tumino R, Piselli P, Dal Maso L, Cancer And Aids Registries Linkage Study Cancer, Aids Registries Linkage Study, Lise M, Zucchetto A, De Paoli A, Intrieri T, Vattiato R, Zambon P, Puppo A, Patriarca S, Tittarelli A, Autelitano M, Cirilli C, La Rosa F, Sgargi P, Di Felice E, Cesaraccio R, Donato F, Franchini S, Zanier L, Vittadello F, Vercellino P, Senatore G, Contrino M, Antonini S, Palombino R, Maspero S, La Rosa M, Camoni L, Regine V. Cancer incidence in people with AIDS in Italy. Int J Cancer. 2010;127:1437–45.
Puoti M, Moioli MC, Travi G, Rossotti R. The burden of liver disease in human immunodeficiency virus-infected patients. Semin Liver Dis. 2012;32(2):103–13.
Rosenthal E, Poiree M, Pradier C, Perronne C, Salmon-Ceron D, Geffray L, Myers RP, Morlat P, Pialoux G, Poi S, Cacoub P. Mortality due to hepatitis C-related liver disease in HIV infected patients in France (Mortavic 2001 study). AIDS. 2003;17:1803–9.
Simard EP, Pfeiffer RM, Engels EA. Spectrum of cancer risk late after AIDS onset in the United States. Arch Intern Med. 2010;170(15):1337–45.
Simard EP, Pfeiffer RM, Engels EA. Cumulative incidence of cancer among individuals with acquired immunodeficiency syndrome in the United States. Cancer. 2011;117(5):1089–96.
Terrault NA, Roland ME, Schiano T, Dove L, Wong MT, Poordad F, Ragni MV, Barin B, Simon D, Olthoff KM, Johnson L, Stosor V, Jayaweera D, Fung J, Sherman KE, Subramanian A, Millis JM, Slakey D, Berg CL, Carlson L, Ferrell L, Stablein DM, Odim J, Fox L, Stock PG. Solid organ transplantation in HIV: multi-site study investigators. Outcomes of liver transplant recipients with hepatitis C and human immunodeficiency virus coinfection. Liver Transpl. 2012;18(6):716–26.
Wood NJ. Liver transplantation: outcomes could be improved in HCV–HIV co-infected liver transplant recipients. Nat Rev Gastroenterol Hepatol. 2012;9(4):190.
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Berretta, M., De Paoli, P., Tirelli, U., Cacopardo, B. (2014). Hepatocellular Carcinoma in HIV-Positive Patients. In: Yarchoan, R. (eds) Cancers in People with HIV and AIDS. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0859-2_23
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DOI: https://doi.org/10.1007/978-1-4939-0859-2_23
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