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HIV RNA, CD4+ Percentage, and Risk of Hepatocellular Carcinoma by Cirrhosis Status.

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Title: HIV RNA, CD4+ Percentage, and Risk of Hepatocellular Carcinoma by Cirrhosis Status.
Authors: Torgersen, Jessie, Kallan, Michael J, Carbonari, Dena M, Park, Lesley S, Mehta, Rajni L, D'Addeo, Kathryn, Tate, Janet P, Lim, Joseph K, Goetz, Matthew Bidwell, Rodriguez-Barradas, Maria C, Gibert, Cynthia L, Bräu, Norbert, Brown, Sheldon T, Roy, Jason A, Taddei, Tamar H, Justice, Amy C, Re, Vincent Lo, Lo Re, Vincent
Source: JNCI: Journal of the National Cancer Institute; Jul2020, Vol. 122 Issue 7, p747-755, 9p, 1 Diagram, 3 Charts
Subject Terms: HEPATOCELLULAR carcinoma, HEALTH services administration, CIRRHOSIS of the liver, RNA, HEPATITIS C, HIV seroconversion, HIV infection epidemiology, HIV infections, LIVER tumors, RETROSPECTIVE studies, VIREMIA, RESEARCH funding, T cells, VETERANS, HIV, LONGITUDINAL method
Geographic Terms: UNITED States
Company/Entity: UNITED States. Veterans Health Administration, UNITED States. Dept. of Veterans Affairs
Abstract: Background: Despite increasing incidence of hepatocellular carcinoma (HCC) among HIV-infected patients, it remains unclear if HIV-related factors contribute to development of HCC. We examined if higher or prolonged HIV viremia and lower CD4+ cell percentage were associated with HCC.Methods: We conducted a cohort study of HIV-infected individuals who had HIV RNA, CD4+, and CD8+ cell counts and percentages assessed in the Veterans Aging Cohort Study (1999-2015). HCC was ascertained using Veterans Health Administration cancer registries and electronic records. Cox regression was used to determine hazard ratios (HR, 95% confidence interval [CI]) of HCC associated with higher current HIV RNA, longer duration of detectable HIV viremia (≥500 copies/mL), and current CD4+ cell percentage less than 14%, adjusting for traditional HCC risk factors. Analyses were stratified by previously validated diagnoses of cirrhosis prior to start of follow-up.Results: Among 35 659 HIV-infected patients, 302 (0.8%) developed HCC over 281 441 person-years (incidence rate = 107.3 per 100 000 person-years). Among patients without baseline cirrhosis, higher HIV RNA (HR = 1.25, 95% CI = 1.12 to 1.40, per 1.0 log10 copies/mL) and 12 or more months of detectable HIV (HR = 1.47, 95% CI = 1.02 to 2.11) were independently associated with higher risk of HCC. CD4+ percentage less than 14% was not associated with HCC in any model. Hepatitis C coinfection was a statistically significant predictor of HCC regardless of baseline cirrhosis status.Conclusion: Among HIV-infected patients without baseline cirrhosis, higher HIV RNA and longer duration of HIV viremia increased risk of HCC, independent of traditional HCC risk factors. This is the strongest evidence to date that HIV viremia contributes to risk of HCC in this group. [ABSTRACT FROM AUTHOR]
Copyright of JNCI: Journal of the National Cancer Institute is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: HIV RNA, CD4+ Percentage, and Risk of Hepatocellular Carcinoma by Cirrhosis Status.
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  Data: <searchLink fieldCode="AR" term="%22Torgersen%2C+Jessie%22">Torgersen, Jessie</searchLink><br /><searchLink fieldCode="AR" term="%22Kallan%2C+Michael+J%22">Kallan, Michael J</searchLink><br /><searchLink fieldCode="AR" term="%22Carbonari%2C+Dena+M%22">Carbonari, Dena M</searchLink><br /><searchLink fieldCode="AR" term="%22Park%2C+Lesley+S%22">Park, Lesley S</searchLink><br /><searchLink fieldCode="AR" term="%22Mehta%2C+Rajni+L%22">Mehta, Rajni L</searchLink><br /><searchLink fieldCode="AR" term="%22D'Addeo%2C+Kathryn%22">D'Addeo, Kathryn</searchLink><br /><searchLink fieldCode="AR" term="%22Tate%2C+Janet+P%22">Tate, Janet P</searchLink><br /><searchLink fieldCode="AR" term="%22Lim%2C+Joseph+K%22">Lim, Joseph K</searchLink><br /><searchLink fieldCode="AR" term="%22Goetz%2C+Matthew+Bidwell%22">Goetz, Matthew Bidwell</searchLink><br /><searchLink fieldCode="AR" term="%22Rodriguez-Barradas%2C+Maria+C%22">Rodriguez-Barradas, Maria C</searchLink><br /><searchLink fieldCode="AR" term="%22Gibert%2C+Cynthia+L%22">Gibert, Cynthia L</searchLink><br /><searchLink fieldCode="AR" term="%22Bräu%2C+Norbert%22">Bräu, Norbert</searchLink><br /><searchLink fieldCode="AR" term="%22Brown%2C+Sheldon+T%22">Brown, Sheldon T</searchLink><br /><searchLink fieldCode="AR" term="%22Roy%2C+Jason+A%22">Roy, Jason A</searchLink><br /><searchLink fieldCode="AR" term="%22Taddei%2C+Tamar+H%22">Taddei, Tamar H</searchLink><br /><searchLink fieldCode="AR" term="%22Justice%2C+Amy+C%22">Justice, Amy C</searchLink><br /><searchLink fieldCode="AR" term="%22Re%2C+Vincent+Lo%22">Re, Vincent Lo</searchLink><br /><searchLink fieldCode="AR" term="%22Lo+Re%2C+Vincent%22">Lo Re, Vincent</searchLink>
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  Data: JNCI: Journal of the National Cancer Institute; Jul2020, Vol. 122 Issue 7, p747-755, 9p, 1 Diagram, 3 Charts
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  Label: Subject Terms
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  Data: <searchLink fieldCode="DE" term="%22HEPATOCELLULAR+carcinoma%22">HEPATOCELLULAR carcinoma</searchLink><br /><searchLink fieldCode="DE" term="%22HEALTH+services+administration%22">HEALTH services administration</searchLink><br /><searchLink fieldCode="DE" term="%22CIRRHOSIS+of+the+liver%22">CIRRHOSIS of the liver</searchLink><br /><searchLink fieldCode="DE" term="%22RNA%22">RNA</searchLink><br /><searchLink fieldCode="DE" term="%22HEPATITIS+C%22">HEPATITIS C</searchLink><br /><searchLink fieldCode="DE" term="%22HIV+seroconversion%22">HIV seroconversion</searchLink><br /><searchLink fieldCode="DE" term="%22HIV+infection+epidemiology%22">HIV infection epidemiology</searchLink><br /><searchLink fieldCode="DE" term="%22HIV+infections%22">HIV infections</searchLink><br /><searchLink fieldCode="DE" term="%22LIVER+tumors%22">LIVER tumors</searchLink><br /><searchLink fieldCode="DE" term="%22RETROSPECTIVE+studies%22">RETROSPECTIVE studies</searchLink><br /><searchLink fieldCode="DE" term="%22VIREMIA%22">VIREMIA</searchLink><br /><searchLink fieldCode="DE" term="%22RESEARCH+funding%22">RESEARCH funding</searchLink><br /><searchLink fieldCode="DE" term="%22T+cells%22">T cells</searchLink><br /><searchLink fieldCode="DE" term="%22VETERANS%22">VETERANS</searchLink><br /><searchLink fieldCode="DE" term="%22HIV%22">HIV</searchLink><br /><searchLink fieldCode="DE" term="%22LONGITUDINAL+method%22">LONGITUDINAL method</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22UNITED+States%22">UNITED States</searchLink>
– Name: SubjectCompany
  Label: Company/Entity
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  Data: <searchLink fieldCode="CO" term="%22UNITED+States%2E+Veterans+Health+Administration%22">UNITED States. Veterans Health Administration</searchLink><br /><searchLink fieldCode="CO" term="%22UNITED+States%2E+Dept%2E+of+Veterans+Affairs%22">UNITED States. Dept. of Veterans Affairs</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: <bold>Background: </bold>Despite increasing incidence of hepatocellular carcinoma (HCC) among HIV-infected patients, it remains unclear if HIV-related factors contribute to development of HCC. We examined if higher or prolonged HIV viremia and lower CD4+ cell percentage were associated with HCC.<bold>Methods: </bold>We conducted a cohort study of HIV-infected individuals who had HIV RNA, CD4+, and CD8+ cell counts and percentages assessed in the Veterans Aging Cohort Study (1999-2015). HCC was ascertained using Veterans Health Administration cancer registries and electronic records. Cox regression was used to determine hazard ratios (HR, 95% confidence interval [CI]) of HCC associated with higher current HIV RNA, longer duration of detectable HIV viremia (≥500 copies/mL), and current CD4+ cell percentage less than 14%, adjusting for traditional HCC risk factors. Analyses were stratified by previously validated diagnoses of cirrhosis prior to start of follow-up.<bold>Results: </bold>Among 35 659 HIV-infected patients, 302 (0.8%) developed HCC over 281 441 person-years (incidence rate = 107.3 per 100 000 person-years). Among patients without baseline cirrhosis, higher HIV RNA (HR = 1.25, 95% CI = 1.12 to 1.40, per 1.0 log10 copies/mL) and 12 or more months of detectable HIV (HR = 1.47, 95% CI = 1.02 to 2.11) were independently associated with higher risk of HCC. CD4+ percentage less than 14% was not associated with HCC in any model. Hepatitis C coinfection was a statistically significant predictor of HCC regardless of baseline cirrhosis status.<bold>Conclusion: </bold>Among HIV-infected patients without baseline cirrhosis, higher HIV RNA and longer duration of HIV viremia increased risk of HCC, independent of traditional HCC risk factors. This is the strongest evidence to date that HIV viremia contributes to risk of HCC in this group. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label:
  Group: Ab
  Data: <i>Copyright of JNCI: Journal of the National Cancer Institute is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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    Identifiers:
      – Type: doi
        Value: 10.1093/jnci/djz214
    Languages:
      – Code: eng
        Text: English
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        PageCount: 9
        StartPage: 747
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      – SubjectFull: UNITED States
        Type: general
      – SubjectFull: UNITED States. Veterans Health Administration
        Type: general
      – SubjectFull: UNITED States. Dept. of Veterans Affairs
        Type: general
      – SubjectFull: HEPATOCELLULAR carcinoma
        Type: general
      – SubjectFull: HEALTH services administration
        Type: general
      – SubjectFull: CIRRHOSIS of the liver
        Type: general
      – SubjectFull: RNA
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      – SubjectFull: HEPATITIS C
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      – SubjectFull: HIV seroconversion
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      – SubjectFull: LIVER tumors
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      – SubjectFull: HIV
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      – TitleFull: HIV RNA, CD4+ Percentage, and Risk of Hepatocellular Carcinoma by Cirrhosis Status.
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