J 2019

Incidence of Hepatocellular Carcinoma in HIV/HBV-coinfected Patients on Tenofovir therapy: Relevance for Screening Strategies

WANDELER, Gilles; Etienne MAURON; Andrew ATKINSON; Jean-François DUFOUR; David KRAUS et. al.

Základní údaje

Originální název

Incidence of Hepatocellular Carcinoma in HIV/HBV-coinfected Patients on Tenofovir therapy: Relevance for Screening Strategies

Autoři

WANDELER, Gilles; Etienne MAURON; Andrew ATKINSON; Jean-François DUFOUR; David KRAUS (203 Česká republika, domácí); Peter REISS; Lars PETERS; François DABIS; Jan FEHR; Enos BERNASCONI; Marc van der VALK; Colette SMIT; Lars K GJÆRDE; Jürgen ROCKSTROH; Didier NEAU; Fabrice BONNET a Andri RAUCH

Vydání

Journal of Hepatology, Amsterdam, ELSEVIER SCIENCE BV, 2019, 0168-8278

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30219 Gastroenterology and hepatology

Stát vydavatele

Nizozemské království

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 20.582

Kód RIV

RIV/00216224:14310/19:00109458

Organizační jednotka

Přírodovědecká fakulta

UT WoS

000475462500010

EID Scopus

2-s2.0-85066398836

Klíčová slova anglicky

Hepatitis B infection; HIV infection; Hepatocellular carcinoma; Screening; Antiretroviral; Nucleotide inhibitors; Surveillance

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 17. 3. 2020 14:57, Mgr. Marie Novosadová Šípková, DiS.

Anotace

V originále

Background and aims Robust data on hepatocellular carcinoma (HCC) incidence among HIV/hepatitis B virus (HBV)-coinfected individuals on antiretroviral therapy (ART) are needed to inform HCC screening strategies. We aimed to evaluate the incidence and risk factors of HCC among HIV/HBV-coinfected individuals on tenofovir disoproxil fumarate (TDF)-containing ART in a large multi-cohort study. Methods We included all HIV-infected adults with a positive hepatitis B surface antigen followed in one of four prospective European cohorts. The primary outcome was the occurrence of HCC. Demographic and clinical information was retrieved from routinely collected data, and liver cirrhosis was defined according to results from liver biopsy or non-invasive measurements. Multivariable Poisson regression was used to assess HCC risk factors. Results 3,625 HIV/HBV-coinfected patients, of whom 72% have initiated TDF-containing ART were included. Over 32,673 patient-years (py), 60 individuals (1.7%) developed an HCC. The incidence of HCC remained stable over time among individuals on TDF, whereas it increased steadily among those not on TDF. Among individuals on TDF, the incidence of HCC was 5.9 per 1,000 py (95% confidence interval [CI] 3.60-9.10) in cirrhotics and 1.17 per 1,000 py (0.56-2.14) among non-cirrhotics. Age at initiation of TDF (adjusted incidence rate ratio per 10 years increase: 2.2, 95% CI 1.6-3.0) and the presence of liver cirrhosis (4.5, 2.3-8.9) were predictors of HCC. Among non-cirrhotic individuals, the incidence of HCC was above the commonly used screening threshold of 2 cases per 1,000 py only in patients aged >46 years at TDF initiation. Conclusions Whereas the incidence of HCC was high in cirrhotic HIV/HBV-coinfected individuals, it remained below the HCC screening threshold in patients initiating TDF without cirrhosis at an age <46 years. Lay summary: We investigated the incidence of hepatocellular carcinoma (HCC) in HIV/HBV-coinfected individuals from a large multi-cohort study in Europe. Over 32,673 patient-years, 60 individuals (1.7%) developed an HCC. The incidence of HCC remained low in patients initiating TDF without cirrhosis at an age <46 years.