Risk of Hepatocellular Carcinoma in People with HIV in the United States, 2001-2019

Menée aux Etats-Unis à l'aide de données de l'étude "HIV/AIDS Cancer Match Study" et de registres des cancers, cette étude évalue le risque de carcinome hépatocellulaire chez les personnes infectées par le VIH

Résumé en anglais

People with HIV (PWH) have higher risk of hepatocellular carcinoma (HCC) than the general population, partly due to higher prevalence of coinfection with hepatitis B virus (HBV) or C virus (HCV).We calculated standardized incidence ratios for HCC in PWH by comparing rates from PWH in the HIV/AIDS Cancer Match Study, a population-based HIV and cancer registry linkage, to those in the general population. We used multivariable Poisson regression to estimate adjusted incidence rate ratios (aIRRs) among PWH and linked the Texas HIV registry with medical claims data to estimate adjusted odds ratios (aORs) of HBV and HCV in HCC cases with logistic regression.Compared to the general population, HCC rates in PWH were elevated 2.79-fold (n = 1,736; 95%CI 2.66-2.92). HCC rates decreased significantly from 2001-2004 to 2015-2019 (p < 0.001). Compared to men who had sex with men (MSM), HCC risk was elevated 4.28-fold among men who injected drugs (95%CI 3.72-4.93) and 1.83-fold among women who injected drugs (95%CI 1.49-2.26). In Texas, 146 HCC cases amongst PWH were linked to claims data; 25% HBV-positive, 59% HCV-positive, and 13% co-infected with HBV and HCV. Compared to MSM, people who inject drugs (PWID) had 82% decreased odds of HBV (aOR 0.18; 95%CI (0.05 – 0.63), and 2-times the odds of HCV (aOR 20.4; 95%CI 3.32-125.3).During 2001-2019, HCC risk declined among PWH, though rates remain significantly elevated compared to the general population, particularly among PWID. Prevention and treatment of HBV/HCV are needed to reduce HCC risk among PWH.