HIV患者和非HIV患者肝细胞癌的表现、治疗和长期结局：一项比较观察性队列研究

IF 2.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hpb Pub Date : 2025-02-21 DOI:10.1016/j.hpb.2025.02.012

Sanju Sobnach, Muhammad Emmamally, Keith Venter, C Wendy Spearman, Inae Kim, Marc Bernon, Mark Sonderup, Urda Kotze, Rajshree Segobin, Dale Creamer, Rufaida Khan, Stefano Cacciatore, Luiz F Zerbini, Eduard Jonas

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引用次数: 0

摘要

背景：本研究探讨了撒哈拉以南队列中肝细胞癌（HCC）的流行病学、治疗和结局，比较了感染和未感染人类免疫缺陷病毒（HIV）的患者。方法：对2011年2月1日至2024年2月29日在南非Groote Schuur医院接受HCC治疗的患者进行回顾性队列研究。结果：501例HCC患者中，75例（15.0%）为HIV感染者（PLWH）。结论：在撒哈拉以南的HCC队列中，HIV患者明显更年轻，疾病更晚期，HBV合并感染导致生存率最低。通过积极的HCC筛查早期发现是改善PLWH预后的关键。

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Presentation, treatment and long-term outcomes of hepatocellular carcinoma in patients with and without HIV: a comparative observational cohort study.

Background: This study explores the epidemiology, treatment and outcomes of hepatocellular carcinoma (HCC) in a sub-Saharan cohort, comparing patients with and without human immunodeficiency virus (HIV).

Methods: A retrospective cohort study of patients treated for HCC from 1 February 2011 to 29 February 2024 at Groote Schuur Hospital, South Africa was performed.

Results: Of the 501 HCC patients, 75 (15.0 %) were people living with HIV (PLWH). The PLWH were younger (43.7 ± 9.7 vs. 52.9 ± 15.3 years, p < 0.00001), had more frequent chronic hepatitis B virus (HBV) co-infection (85.3 % vs. 51.6 %, p < 0.00001) and no hepatitis C virus co-infection (0 % vs. 6.8 %, p = 0.013). More PLWH presented with Barcelona Clinic Liver Cancer Stage D disease (43.6 % vs. 27.7 %, p = 0.007). Similar proportions of PLWH and HIV-negative patients received curative-intended treatments, life-prolonging therapies and best supportive care. In PLWH, the median survival was lower (44 [IQR: 16-163.7] vs. 78 [IQR: 26-191] days, p = 0.010), and patients with HIV-HBV co-infection had the lowest survival (39 [IQR: 14.7-155.2] days).

Conclusion: In a sub-Saharan HCC cohort, patients with HIV were significantly younger, had more advanced disease and HBV co-infection resulted in the lowest survival. Earlier detection through aggressive HCC screening is key to improving outcomes in PLWH.

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来源期刊

Hpb GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.60

自引率

3.40%

发文量

244

审稿时长

57 days

期刊介绍： HPB is an international forum for clinical, scientific and educational communication. Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice. Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice. HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields. Abstracted and Indexed in: MEDLINE® EMBASE PubMed Science Citation Index Expanded Academic Search (EBSCO) HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).